Sex differences in outcome after ventricular fibrillation in out-of-hospital cardiac arrest

Srijoy Mahapatra, T. Jared Bunch, Roger D. White, David O. Hodge, Douglas L. Packer

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Introduction: Previous studies have shown that early defibrillation programs improve survival after an out-of-hospital cardiac arrest (OHCA). Reports also suggest that women fare worse than men do after cardiovascular events, but there is no population-based study of sex differences after an OHCA with early defibrillation. We, therefore, compared the short- and long-term survival and quality-of-life (QOL) in women and men after an OHCA. Methods: All patients with a ventricular fibrillation (VF) OHCA who received early defibrillation in Olmstead County, Minnesota between November 1990 and December 2000 were included. Using medical records and the cardiac arrest database, the short- and long-term survival and QOL based on a SF-36 survey of each sex were compared. Adjusted QOL scores were obtained by using age- and sex-specific norms from a sample of the general U.S. population; an adjusted score of 50 (normalized mean) was considered normal. Results: Thirty-seven female and 163 male patients presented with a VF OHCA and early defibrillation. Survival to hospital admission was significantly better for women than men [30 female survivors to admission (81%), 112 male (69%), p = 0.04]. Paradoxically, survival to discharge among those admitted was worse for women [13 female survivors to discharge (43%), 66 male (61%), p = 0.04]. The average length of follow-up was 4.8 ± 3.0 years. The 5-year expected survival was 83% in women and 78% in men (p = 0.48). There was no difference in call-to-shock time (6 ± 2, 6 ± 2 min, p = 0.6) or whether the arrest was witnessed (86, 82%, p = 0.64). There was no statistical difference between women and men in age (64 ± 17, 65 ± 14 years), ejection fraction (40 ± 17, 40 ± 18%), diabetes (17, 29%, p = 0.16), hypertension (23, 28%, p = 0.58) or known CAD (27, 48%, p = 0.06). Adjusted QOL scores were similar between women and men in terms of pain (52 ± 9, 52 ± 10) vitality (47 ± 11, 40 ± 9), general health (49 ± 9, 44 ± 7), social function (51 ± 10, 51 ± 8), and mental health (50 ± 10, 49 ± 6). Conclusion: Women are more likely to survive to hospital admission following an OHCA. However, admitted women less likely to survive their hospital stay. Long-term survival and QOL are equally favorable in both sexes.

Original languageEnglish (US)
Pages (from-to)197-202
Number of pages6
JournalResuscitation
Volume65
Issue number2
DOIs
StatePublished - May 2005

Keywords

  • Automated implantable cardiovertor defibrillator (AICD)
  • Cardiac arrest
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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