Angela Meier1, Jenny Yang2, Jinyuan Liu3, Jeremy R Beitler4, Xin M Tu3, Robert L Owens2, Radhika L Sundararajan5, Atul Malhotra2, Rebecca E Sell2,6. 1. Division of Critical Care, Department of Anesthesiology, University of California San Diego, San Diego, CA. 2. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Diego, San Diego, CA. 3. Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA. 4. Center for Acute Respiratory Failure and Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY. 5. Center for Global Health and Division of Emergency Medicine, Department of Emegency Medicine, Weill Cornell Medicine, Cornell University, New York, NY. 6. Department of Veterans Affairs, San Diego, CA.
Abstract
OBJECTIVES: A recently published simulation study suggested that women are inferior leaders of cardiopulmonary resuscitation efforts. The aim of this study was to compare female and male code leaders in regard to cardiopulmonary resuscitation outcomes in a real-world clinical setting. DESIGN: Retrospective cohort review. SETTING: Two academic, urban hospitals in San Diego, California. SUBJECTS: One-thousand eighty-two adult inpatients who suffered cardiac arrest and underwent cardiopulmonary resuscitation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed whether physician code leader gender was independently associated with sustained return of spontaneous circulation and survival to discharge and with markers of quality cardiopulmonary resuscitation. Of all arrests, 327 (30.1%) were run by female physician code leaders with 251 (76.8%) obtaining return of spontaneous circulation, and 122 (37.3%) surviving to discharge. Male physicians ran 757 codes obtaining return of spontaneous circulation in 543 (71.7%) with 226 (29.9%) surviving to discharge. When adjusting for variables, female physician code leader gender was independently associated with a higher likelihood of return of spontaneous circulation (odds ratio, 1.36; 95% CI, 1.01-1.85; p = 0.049) and survival to discharge (odds ratio, 1.53; 95% CI, 1.15-2.02; p < 0.01). Additionally, the odds ratio for survival to discharge was 1.62 (95% CI, 1.13-2.34; p < 0.01) for female physicians with a female code nurse when compared with male physician code leaders paired with a female code nurse. Gender of code leader was not associated with cardiopulmonary resuscitation quality. CONCLUSIONS: In contrast to data derived from a simulated setting with medical students, real life female physician leadership of cardiopulmonary resuscitation is not associated with inferior outcomes. Appropriately, trained physicians can lead high-quality cardiopulmonary resuscitation irrespective of gender.
OBJECTIVES: A recently published simulation study suggested that women are inferior leaders of cardiopulmonary resuscitation efforts. The aim of this study was to compare female and male code leaders in regard to cardiopulmonary resuscitation outcomes in a real-world clinical setting. DESIGN: Retrospective cohort review. SETTING: Two academic, urban hospitals in San Diego, California. SUBJECTS: One-thousand eighty-two adult inpatients who suffered cardiac arrest and underwent cardiopulmonary resuscitation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We analyzed whether physician code leader gender was independently associated with sustained return of spontaneous circulation and survival to discharge and with markers of quality cardiopulmonary resuscitation. Of all arrests, 327 (30.1%) were run by female physician code leaders with 251 (76.8%) obtaining return of spontaneous circulation, and 122 (37.3%) surviving to discharge. Male physicians ran 757 codes obtaining return of spontaneous circulation in 543 (71.7%) with 226 (29.9%) surviving to discharge. When adjusting for variables, female physician code leader gender was independently associated with a higher likelihood of return of spontaneous circulation (odds ratio, 1.36; 95% CI, 1.01-1.85; p = 0.049) and survival to discharge (odds ratio, 1.53; 95% CI, 1.15-2.02; p < 0.01). Additionally, the odds ratio for survival to discharge was 1.62 (95% CI, 1.13-2.34; p < 0.01) for female physicians with a female code nurse when compared with male physician code leaders paired with a female code nurse. Gender of code leader was not associated with cardiopulmonary resuscitation quality. CONCLUSIONS: In contrast to data derived from a simulated setting with medical students, real life female physician leadership of cardiopulmonary resuscitation is not associated with inferior outcomes. Appropriately, trained physicians can lead high-quality cardiopulmonary resuscitation irrespective of gender.
Authors: Simon Adrian Amacher; Cleo Schumacher; Corinne Legeret; Franziska Tschan; Norbert Karl Semmer; Stephan Marsch; Sabina Hunziker Journal: Crit Care Med Date: 2017-07 Impact factor: 7.598
Authors: Ian G Stiell; Siobhan P Brown; Graham Nichol; Sheldon Cheskes; Christian Vaillancourt; Clifton W Callaway; Laurie J Morrison; James Christenson; Tom P Aufderheide; Daniel P Davis; Cliff Free; Dave Hostler; John A Stouffer; Ahamed H Idris Journal: Circulation Date: 2014-09-24 Impact factor: 29.690
Authors: Yusuke Tsugawa; Anupam B Jena; Jose F Figueroa; E John Orav; Daniel M Blumenthal; Ashish K Jha Journal: JAMA Intern Med Date: 2017-02-01 Impact factor: 21.873
Authors: Lauren E Thompson; Paul S Chan; Fengming Tang; Brahmajee K Nallamothu; Saket Girotra; Sarah M Perman; Somnath Bose; Stacie L Daugherty; Steven M Bradley Journal: Resuscitation Date: 2017-11-02 Impact factor: 5.262
Authors: Seraina Rahel Hochstrasser; Simon Adrian Amacher; Franziska Tschan; Norbert Karl Semmer; Christoph Becker; Kerstin Metzger; Sabina Hunziker; Stephan Marsch Journal: Med Educ Date: 2021-09-12 Impact factor: 7.647
Authors: Elizabeth D Rosenman; Anthony Misisco; Jeffrey Olenick; Sarah M Brolliar; Anne K Chipman; Marie C Vrablik; Georgia T Chao; Steve W J Kozlowski; James A Grand; Rosemarie Fernandez Journal: J Am Coll Emerg Physicians Open Date: 2021-01-04