Chih-Hung Wang1, Chien-Hua Huang2, Wei-Tien Chang2, Min-Shan Tsai2, Ping-Hsun Yu3, Yen-Wen Wu4, Wen-Jone Chen5. 1. Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. 2. Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 3. Department of Emergency Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan. 4. Departments of Internal Medicine and Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Nuclear Medicine and Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; National Yang-Ming University School of Medicine, Taipei, Taiwan. 5. Department of Emergency Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Emergency Medicine, Lotung Poh-Ai Hospital, Yilan, Taiwan. Electronic address: wjchen1955@ntu.edu.tw.
Abstract
AIM: To analyse the association between gender and outcomes of in-hospital cardiac arrest (IHCA) and the influences of age and marital status on the gender-based difference in clinical outcome. METHODS: This retrospective observational study conducted in a single medical centre evaluated patients who had experienced IHCA from 2006 to 2014. Multivariate logistic regression analysis was used to study associations between independent variables and outcomes. Patients 18-49 years old were considered of reproductive age. The presence or absence of a legitimate spouse was retrieved from the family pedigree presented in the medical records. Reproductive age and marital status were each analysed as an interaction term with gender. RESULTS: A total of 1524 patients, of which 598 were women (39.2%), were included in this study. There were 269 patients (17.7%) of reproductive age and 490 patients (32.2%) without a living spouse. Only 215 patients (14.1%) survived to hospital discharge. Among these, 110 patients (7.2%) demonstrated a favourable neurological status. Our analysis indicated that being female was inversely associated with a favourable neurological outcome (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.29-0.87; p=0.02). Being female without a living spouse was inversely associated with a favourable neurological outcome (OR, 0.43; 95% CI, 0.17-0.96; p=0.05). Neither female nor female-associated interaction terms were significantly associated with survival to hospital discharge. CONCLUSION: Female patients with IHCA had worse neurological outcomes than their male counterparts, especially for women without a living spouse. However, survival outcome did not differ between genders.
AIM: To analyse the association between gender and outcomes of in-hospital cardiac arrest (IHCA) and the influences of age and marital status on the gender-based difference in clinical outcome. METHODS: This retrospective observational study conducted in a single medical centre evaluated patients who had experienced IHCA from 2006 to 2014. Multivariate logistic regression analysis was used to study associations between independent variables and outcomes. Patients 18-49 years old were considered of reproductive age. The presence or absence of a legitimate spouse was retrieved from the family pedigree presented in the medical records. Reproductive age and marital status were each analysed as an interaction term with gender. RESULTS: A total of 1524 patients, of which 598 were women (39.2%), were included in this study. There were 269 patients (17.7%) of reproductive age and 490 patients (32.2%) without a living spouse. Only 215 patients (14.1%) survived to hospital discharge. Among these, 110 patients (7.2%) demonstrated a favourable neurological status. Our analysis indicated that being female was inversely associated with a favourable neurological outcome (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.29-0.87; p=0.02). Being female without a living spouse was inversely associated with a favourable neurological outcome (OR, 0.43; 95% CI, 0.17-0.96; p=0.05). Neither female nor female-associated interaction terms were significantly associated with survival to hospital discharge. CONCLUSION: Female patients with IHCA had worse neurological outcomes than their male counterparts, especially for women without a living spouse. However, survival outcome did not differ between genders.
Authors: Sarah M Perman; Bonnie J Siry; Adit A Ginde; Anne V Grossestreuer; Benjamin S Abella; Stacie L Daugherty; Edward P Havranek Journal: Clin Ther Date: 2019-04-30 Impact factor: 3.393