TY - JOUR
T1 - Gender-related differences in adults concerning frequency, survival and treatment quality after out-of-hospital cardiac arrest (OHCA)
T2 - An observational cohort study from the German resuscitation registry
AU - Böckler, Bastian
AU - Preisner, Achim
AU - Bathe, Janina
AU - Rauch, Stefan
AU - Ristau, Patrick
AU - Wnent, Jan
AU - Gräsner, Jan Thorsten
AU - Seewald, Stephan
AU - Lefering, Rolf
AU - Fischer, Matthias
N1 - Publisher Copyright:
© 2023 Elsevier B.V.
PY - 2024/1
Y1 - 2024/1
N2 - Background: In Germany approximately 20,500 women and 41,000 men were resuscitated after out-of-hospital cardiac arrest (OHCA) each year. We are currently experiencing a discussion about the possible undersupply of women in healthcare. The aim of the present study was to examine the prevalence of OHCA in Germany, as well as the outcome and quality of resuscitation care for both women and men. Methods: We present a cohort study from the German Resuscitation Registry (2006–2022). The quality of care was assessed for both EMS and hospital care based on risk-adjusted survival rates with the endpoints: “hospital admission with return of spontaneous circulation” (ROSCadmission) for all patients and ”discharge with favourable neurological recovery“ (CPC1/2discharge) for all admitted patients. Risk adjustment was performed using logistic regression analysis (LRA). If sex was significantly associated with survival, a matched-pairs-analysis (MPA) followed to explore the frequency of guideline adherence. Results: 58,798 patients aged ≥ 18 years with OHCA and resuscitation were included (men = 65.2%, women = 34.8%). In the prehospital phase the male gender was associated with lower ROSCadmission-rate (LRA: OR = 0.79, CI = 0.759–0.822). A total of 27,910 patients were admitted. During hospital care, men demonstrated a better prognosis (OR = 1.10; CI = 1.015–1.191). MPA revealed a more intensive therapy for men both during EMS and hospital care. Looking at the complete chain of survival, LRA revealed no difference for men and women concerning CPC1/2discharge (n = 58,798; OR = 0.95; CI = 0.888–1.024). Conclusion: In Germany, 80% more men than women experience OHCA. The prognosis for CPC1/2discharge remains low (men = 10.5%, women = 7.1%), but comparable after risk adjustment. There is evidence of undersupply of care for women during hospital treatment, which could be associated with a worse prognosis. Further investigations are required to clarify these findings.
AB - Background: In Germany approximately 20,500 women and 41,000 men were resuscitated after out-of-hospital cardiac arrest (OHCA) each year. We are currently experiencing a discussion about the possible undersupply of women in healthcare. The aim of the present study was to examine the prevalence of OHCA in Germany, as well as the outcome and quality of resuscitation care for both women and men. Methods: We present a cohort study from the German Resuscitation Registry (2006–2022). The quality of care was assessed for both EMS and hospital care based on risk-adjusted survival rates with the endpoints: “hospital admission with return of spontaneous circulation” (ROSCadmission) for all patients and ”discharge with favourable neurological recovery“ (CPC1/2discharge) for all admitted patients. Risk adjustment was performed using logistic regression analysis (LRA). If sex was significantly associated with survival, a matched-pairs-analysis (MPA) followed to explore the frequency of guideline adherence. Results: 58,798 patients aged ≥ 18 years with OHCA and resuscitation were included (men = 65.2%, women = 34.8%). In the prehospital phase the male gender was associated with lower ROSCadmission-rate (LRA: OR = 0.79, CI = 0.759–0.822). A total of 27,910 patients were admitted. During hospital care, men demonstrated a better prognosis (OR = 1.10; CI = 1.015–1.191). MPA revealed a more intensive therapy for men both during EMS and hospital care. Looking at the complete chain of survival, LRA revealed no difference for men and women concerning CPC1/2discharge (n = 58,798; OR = 0.95; CI = 0.888–1.024). Conclusion: In Germany, 80% more men than women experience OHCA. The prognosis for CPC1/2discharge remains low (men = 10.5%, women = 7.1%), but comparable after risk adjustment. There is evidence of undersupply of care for women during hospital treatment, which could be associated with a worse prognosis. Further investigations are required to clarify these findings.
UR - http://www.scopus.com/inward/record.url?scp=85179115355&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2023.110060
DO - 10.1016/j.resuscitation.2023.110060
M3 - Journal articles
C2 - 38013146
AN - SCOPUS:85179115355
SN - 0300-9572
VL - 194
JO - Resuscitation
JF - Resuscitation
M1 - 110060
ER -