Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men.
OBJECTIVE
Estrogen and progesterone improve neurologic outcomes in experimental models of cardiac arrest and stroke. Our objective was to determine whether women of child-bearing age are more likely than men to survive to hospital discharge after in-hospital cardiac arrest.


METHODS
Prospective, observational study.


METHODS
Five hundred nineteen hospitals in the National Registry of Cardiopulmonary Resuscitation database.


METHODS
Patients included 95,852 men and women 15-44 yrs and 56 yrs or older with pulseless cardiac arrests from January 1, 2000 through July 31, 2008.


RESULTS
Patients were stratified a priori by gender and age groups (15-44 yrs and > or =56 yrs). Fixed-effects regression conditioning on hospital was used to examine the relationship between age, gender, and survival outcomes. The unadjusted survival to discharge rate for younger women of child-bearing age (15-44 yrs) was 19% (940/4887) vs. 17% (1203/7025) for younger men (p = .013). The adjusted hospital discharge difference between these younger women and men was 2.8% (95% confidence interval, 1.0% to 4.6%; p = .002), and these younger women also had a 2.6% (95% confidence interval, 0.9% to 4.3%; p = .002) absolute increase in favorable neurologic outcome. For older women compared with men (> or =56 yrs), there were no demonstrable differences in discharge rates (18% vs. 18%; adjusted difference, -0.1%; 95% confidence interval, -0.9% to 0.6%; p = .68) or favorable neurologic outcome (14% vs. 14%; adjusted difference, -0.1%; 95% confidence interval, -0.7% to 0.5%; p = .74).


CONCLUSIONS
Women of child-bearing age were more likely than comparably aged men to survive to hospital discharge after in-hospital cardiac arrest, even after controlling for etiology of arrest and other important variables.
Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. topjian@email.chop.edu
Alexis A
AA
Topjian
A Russell
AR
Localio
Robert A
RA
Berg
Evaline A
EA
Alessandrini
Peter A
PA
Meaney
Paul E
PE
Pepe
G Luke
GL
Larkin
Mary Ann
MA
Peberdy
Lance B
LB
Becker
Vinay M
VM
Nadkarni
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006323:Heart Arrest / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D015996:Survival Rate; D055815:Young Adult