Sex Differences in Cardiac Arrest Survivors Who Receive Therapeutic Hypothermia

Authors

Marna R. Greenberg DO, MPH, FACEP, Lehigh Valley Health NetworkFollow
Amy M. Ahnert MD, Lehigh Valley Health NetworkFollow
Nainesh C. Patel MD, Lehigh Valley Health NetworkFollow
Courtney Bennett DO, Lehigh Valley Health NetworkFollow
Nicole Elliott DO, Lehigh Valley Health Network
Mark Lundquist MD, Lehigh Valley Health NetworkFollow
Andrew C. Miller DO, Lehigh Valley Health NetworkFollow
Ellina C. Feiner MD, Lehigh Valley Health NetworkFollow
Anita Kurt PhD, RN, Lehigh Valley Health NetworkFollow
Bernadette Gl-Porter BS, Lehigh Valley Health NetworkFollow
Mercedes Rios-Scott BS, Lehigh Valley Health NetworkFollow
David B. Burmeister DO, FACEP, Lehigh Valley Health NetworkFollow

Publication/Presentation Date

2-14-2014

Abstract

OBJECTIVE: Sex differences have not been well defined for patients undergoing therapeutic hypothermia (TH). We aimed to determine sex differences in mortality and Cerebral Performance Category (CPC) scores at discharge among those receiving TH.

METHODS: This retrospective cohort study used data abstracted from an "ICE alert" database, an institutional protocol expediting mild TH for postarrest patients. Quality assurance variables (such as age, time to TH, CPC scores, and mortality) were reviewed and compared by sex. χ(2) Test and Wilcoxon rank sum test were used. Stepwise logistic regression was used to assess the association between mortality and sex, while controlling for patient characteristics and clinical presentation of cardiac arrest.

RESULTS: Three hundred thirty subjects were analyzed, 198 males and 132 females. Subjects' mean age (SD) was 61.7 years (15.0); there was no significant sex difference in age. There were no statistically significant sex differences in history of coronary artery disease, congestive heart failure, arrhythmia, hypertension, chronic obstructive pulmonary disease, renal disease, type 1 and/or type 2 diabetes mellitus, or those previously healthy. Obesity (body mass index >35 kg/m(2)) was more likely in females (37, 28.0%) than males (35, 17.7%); P = .03. Females (64, 49.6%) were more likely than males (71, 36.8%) to have shock; P = .02. There was no difference in arrest to initiating hypothermia, but there was a significant difference in time to target temperature (in median minutes, interquartile range): male (440, 270) vs female (310, 270), P = .003. There was no statistical difference in CPC at discharge. Crude mortality was not different between sexes: male, 67.7%; female, 70.5%; P = .594. However, after controlling for differences in age, obesity, shock, and other variables, females were less likely to die (odds ratio, 0.46; 95% confidence interval, 0.23-0.92; P = .03) than males.

CONCLUSION: There is no statistically significant difference in CPC or crude mortality outcomes between sexes. After adjusting for confounders, females were 54% less likely to die than males.

Volume

32

Issue

6

First Page

545

Last Page

548

ISSN

1532-8171

Published In/Presented At

Greenberg, M., Ahnert, A., Patel, N., Bennett, C., Elliott, N., Lundquist, M., & ... Burmeister, D. (2014). Sex differences in cardiac arrest survivors who receive therapeutic hypothermia. The American Journal Of Emergency Medicine, 32(6), 545-548. doi:10.1016/j.ajem.2014.02.004

Disciplines

Cardiology | Emergency Medicine | Medical Specialties | Medicine and Health Sciences

PubMedID

24637139

LVHN link

http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=24637139&site=ehost-live&scope=site

Department(s)

Department of Emergency Medicine, Department of Emergency Medicine Faculty, Department of Emergency Medicine Residents, Department of Medicine, Cardiology Division, Department of Medicine Fellows and Residents, Patient Care Services / Nursing

Document Type

Article