Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men

Alexis A. Topjian, A. Russell Localio, Robert A. Berg, Evaline A. Alessandrini, Peter A. Meaney, Paul E. Pepe, G. Luke Larkin, Mary Ann Peberdy, Lance B. Becker, Vinay M. Nadkarni

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

Objectives: Estrogen and progesterone improve neurologic outcomes in experimental models of cardiac arrest and stroke. Our objective was to determine whether women of child-bearing age are more likely than men to survive to hospital discharge after in-hospital cardiac arrest. Design: Prospective, observational study. Setting: Five hundred nineteen hospitals in the National Registry of Cardiopulmonary Resuscitation database. Patients: Patients included 95,852 men and women 15-44 yrs and 56 yrs or older with pulseless cardiac arrests from January 1, 2000 through July 31, 2008. Measurements and main results: Patients were stratified a priori by gender and age groups (15-44 yrs and ≥56 yrs). Fixed-effects regression conditioning on hospital was used to examine the relationship between age, gender, and survival outcomes. The unadjusted survival to discharge rate for younger women of child-bearing age (15-44 yrs) was 19% (940/4887) vs. 17% (1203/7025) for younger men (p =.013). The adjusted hospital discharge difference between these younger women and men was 2.8% (95% confidence interval, 1.0% to 4.6%; p =.002), and these younger women also had a 2.6% (95% confidence interval, 0.9% to 4.3%; p =.002) absolute increase in favorable neurologic outcome. For older women compared with men (≥56 yrs), there were no demonstrable differences in discharge rates (18% vs. 18%; adjusted difference,-0.1%; 95% confidence interval,-0.9% to 0.6%; p =.68) or favorable neurologic outcome (14% vs. 14%; adjusted difference,-0.1%; 95% confidence interval,-0.7% to 0.5%; p =.74). Conclusions: Women of child-bearing age were more likely than comparably aged men to survive to hospital discharge after in-hospital cardiac arrest, even after controlling for etiology of arrest and other important variables.

Original languageEnglish (US)
Pages (from-to)1254-1260
Number of pages7
JournalCritical care medicine
Volume38
Issue number5
DOIs
StatePublished - May 2010

Keywords

  • Cardiopulmonary resuscitation
  • Gender
  • Heart arrest
  • Outcome
  • Women

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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