Sachin Agarwal1, Alex Presciutti2, Jayati Verma2, Marykay A Pavol2, Deepti Anbarasan2, Daniel Brodie3, Leroy E Rabbani3, David J Roh2, Soojin Park2, Jan Claassen2, Yaakov Stern2. 1. Department of Neurology, Columbia University College of Physicians & Surgeons, New York Presbyterian Hospital/Columbia, New York, NY 10032, United States. Electronic address: sa2512@columbia.edu. 2. Department of Neurology, Columbia University College of Physicians & Surgeons, New York Presbyterian Hospital/Columbia, New York, NY 10032, United States. 3. Department of Internal Medicine, Columbia University College of Physicians & Surgeons, New York Presbyterian Hospital/Columbia, New York, NY 10032, United States.
Abstract
AIM: To examine gender differences among cardiac arrest (CA) survivors' cognitive, functional, and psychiatric outcomes at discharge. METHODS: This is a prospective, observational cohort of 187 CA patients admitted to Columbia University Medical Center, considered for Targeted Temperature Management (TTM), and survived to hospital discharge between September 2015 and July 2017. Patients with sufficient mental status at hospital discharge to engage in the Repeatable Battery for Neuropsychological Status (RBANS), Modified Lawton Physical Self-Maintenance Scale (M-PSMS), Cerebral Performance Category Scale (CPC), Center for Epidemiological Studies Depression Scale (CES-D), and Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) were included. Fisher's exact, Wilcoxon Rank Sum, and regression analysis were utilized. RESULTS: 80 patients (38% women, 44% white, mean age 53 ± 17 years) were included. No significant gender differences were found for age, race, Charlson Comorbidity Index, premorbid CPC or psychiatric diagnoses, arrest related variables, discharge CPC, or PCL-C scores. Women had significantly worse RBANS (64.9 vs 74.8, p = .01), M-PSMS (13.6 vs 10.6, p = .02), and CES-D (22.8 vs 14.3, p = .02) scores. These significant differences were maintained in multivariate models after adjusting for age, initial rhythm, time to return of spontaneous circulation, and TTM. CONCLUSIONS: Women have worse cognitive, functional, and psychiatric outcomes at hospital discharge after cardiac arrest than men. Identifying factors contributing to these differences is of great importance in cardiac arrest outcomes research.
AIM: To examine gender differences among cardiac arrest (CA) survivors' cognitive, functional, and psychiatric outcomes at discharge. METHODS: This is a prospective, observational cohort of 187 CA patients admitted to Columbia University Medical Center, considered for Targeted Temperature Management (TTM), and survived to hospital discharge between September 2015 and July 2017. Patients with sufficient mental status at hospital discharge to engage in the Repeatable Battery for Neuropsychological Status (RBANS), Modified Lawton Physical Self-Maintenance Scale (M-PSMS), Cerebral Performance Category Scale (CPC), Center for Epidemiological Studies Depression Scale (CES-D), and Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) were included. Fisher's exact, Wilcoxon Rank Sum, and regression analysis were utilized. RESULTS: 80 patients (38% women, 44% white, mean age 53 ± 17 years) were included. No significant gender differences were found for age, race, Charlson Comorbidity Index, premorbid CPC or psychiatric diagnoses, arrest related variables, discharge CPC, or PCL-C scores. Women had significantly worse RBANS (64.9 vs 74.8, p = .01), M-PSMS (13.6 vs 10.6, p = .02), and CES-D (22.8 vs 14.3, p = .02) scores. These significant differences were maintained in multivariate models after adjusting for age, initial rhythm, time to return of spontaneous circulation, and TTM. CONCLUSIONS:Women have worse cognitive, functional, and psychiatric outcomes at hospital discharge after cardiac arrest than men. Identifying factors contributing to these differences is of great importance in cardiac arrest outcomes research.
Authors: Sachin Agarwal; Alex Presciutti; Talea Cornelius; Jeffrey Birk; David J Roh; Soojin Park; Jan Claassen; Mitchell S V Elkind; Donald Edmondson Journal: Crit Care Med Date: 2019-06 Impact factor: 7.598
Authors: Alex Presciutti; Jonathan Shaffer; Jennifer A Sumner; Mitchell S V Elkind; David J Roh; Soojin Park; Jan Claassen; Donald Edmondson; Sachin Agarwal Journal: Ann Behav Med Date: 2020-05-25
Authors: Saraschandra Vallabhajosyula; Dhiran Verghese; Viral K Desai; Pranathi R Sundaragiri; Virginia M Miller Journal: Cardiovasc Res Date: 2022-02-21 Impact factor: 10.787