Gender and survival after sudden cardiac arrest: A systematic review and meta-analysis |
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| Affiliation: | 1. Paris Descartes University, France;2. Paris Cardiovascular Research Center – INSERM U970 (PARCC), France;3. Intensive Care Unit, Cochin Hospital, Paris, France;4. Paris Sudden Death Expertise Center, Paris, France;5. Cardiology Department, European Georges Pompidou Hospital, Paris, France;6. Division of Preventive Medicine, Mayo Clinic, Rochester, MN 55905, USA;7. Emergency Department, Cochin Hospital, Paris, France;8. SAMU de Paris, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France;9. Sydney Medical School, Australia;1. Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus Medical Center, The Netherlands;2. Department of Public Health, Erasmus Medical Center, The Netherlands;1. Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA;2. Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark;3. Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA;4. Department of Anesthesia Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA;5. Department of Emergency Medicine, Emory University School of Medicine, Rollins School of Public Health, Atlanta, GA, USA;6. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA |
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| Abstract: | BackgroundConflicting results exist regarding the impact of gender on early survival after sudden cardiac arrest (SCA). We aimed to assess the association between female gender and early SCA survival.MethodsWe searched Embase, MEDLINE, EBM Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (between 1948 and January 2014) for studies evaluating the association between gender and survival after SCA. Two independent reviewers selected studies of any design or language. Pooled odds-ratios (OR) and 95% confidence intervals (CIs) were estimated using a random-effects model. Additional sensitivity analyses and meta-regression were carried out to explore heterogeneity.ResultsThirteen studies were included involving 409,323 patients. Women were more likely to present with SCA at home, less likely to have witnessed SCA, had a lower frequency of initial shockable rhythm but were more likely to receive bystander CPR. After adjustment for these differences, women were more likely to survive at hospital discharge (OR 1.1, 95% CI 1.03–1.20, p = 0.006, I2 = 61%). This association persisted in multiple sensitivity analyses.ConclusionThis meta-analysis of observational studies demonstrates that women have increased odds of survival after SCA. Further studies are needed to address mechanisms explaining this discrepancy. |
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| Keywords: | Sudden death Sex Ventricular fibrillation Gender Prognosis Out-of-hospital cardiac arrest |
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