title: Association of gender to outcome after out-of-hospital cardiac arrest--a report from the International Cardiac Arrest Registry.
abstract: BACKGROUND
  Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate the association of gender to outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH).
  
  
  METHODS
  We performed a retrospective analysis of prospectively collected data from the International Cardiac Arrest Registry. Adult patients with a non-traumatic OHCA and treated with MIH were included. Good neurological outcome was defined as a cerebral performance category (CPC) of 1 or 2.
  
  
  RESULTS
  A total of 1,667 patients, 472 women (28%) and 1,195 men (72%), met the inclusion criteria. Men were more likely to receive bystander cardiopulmonary resuscitation, have an initial shockable rhythm and to have a presumed cardiac cause of arrest. At hospital discharge, men had a higher survival rate (52% vs. 38%, P < 0.001) and more often a good neurological outcome (43% vs. 32%, P < 0.001) in the univariate analysis. When adjusting for baseline characteristics, male gender was associated with improved survival (OR 1.34, 95% CI 1.01 to 1.78) but no longer with neurological outcome (OR 1.24, 95% CI 0.92 to 1.67). Adverse events were common; women more often had hypokalemia, hypomagnesemia and bleeding requiring transfusion, while men had more pneumonia. In a subgroup analysis of patients with a presumed cardiac cause of arrest (n = 1,361), men more often had CAG performed on admission (58% vs. 50%, P = 0.02) but this discrepancy disappeared in an adjusted analysis.
  
  
  CONCLUSIONS
  Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.
authors.affiliation: Department of Clinical Sciences, Lund University, 22184, Lund, Sweden. viktorkarlsson85@gmail.com.
authors.forename: Viktor
authors.initials: V
authors.lastname: Karlsson
authors.affiliation: Department of Clinical Sciences, Lund University, 22184, Lund, Sweden. josef.dankiewicz@gmail.com.|Department of Anaesthesiology and Intensive Care, Skåne University Hospital, Lund, 22185, Sweden. josef.dankiewicz@gmail.com.
authors.forename: Josef
authors.initials: J
authors.lastname: Dankiewicz
authors.affiliation: Department of Clinical Sciences, Lund University, 22184, Lund, Sweden. niklas.nielsen@telia.com.|Department of Anaesthesiology and Intensive Care, Helsingborg Hospital, 25187, Helsingborg, Sweden. niklas.nielsen@telia.com.
authors.forename: Niklas
authors.initials: N
authors.lastname: Nielsen
authors.affiliation: Sarver Heart Center, University of Arizona, 1501 N Campbell Ave, Tucson, AZ, 85724, USA. kernk@email.arizona.edu.
authors.forename: Karl B
authors.initials: KB
authors.lastname: Kern
authors.affiliation: Minneapolis Heart Institute Foundation, Abbot Northwestern Hospital, 920 E 28th Street 100, Minneapolis, MN, 55407, USA. Michael.Mooney@allina.com.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Mooney
authors.affiliation: Department of Critical Care Services and Neuroscience Institute, Maine Medical Center, 22 Bramhall Street, Portland, ME, 04102, USA. RRiker@cmamaine.com.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Riker
authors.affiliation: Department of Surgical Sciences/Anaesthesiology and Intensive Care, Uppsala University, Akademiska sjukhuset, 75185, Uppsala, Sweden. sten.rubertsson@akademiska.se.
authors.forename: Sten
authors.initials: S
authors.lastname: Rubertsson
authors.affiliation: Department of Critical Care Services and Neuroscience Institute, Maine Medical Center, 22 Bramhall Street, Portland, ME, 04102, USA. DSeder@cmamaine.com.
authors.forename: David B
authors.initials: DB
authors.lastname: Seder
authors.affiliation: Department of Anesthesia and Intensive Care, Centre Hospitalier de Luxembourg, 4, rue Barblé, L-1210, Luxembourg, Luxembourg. Stammet.Pascal@chl.lu.
authors.forename: Pascal
authors.initials: P
authors.lastname: Stammet
authors.affiliation: Department of Anaesthesiology, Surgical ICU Ullevål, Oslo University Hospital, Oslo, Norway. kjetil.sunde@medisin.uio.no.
authors.forename: Kjetil
authors.initials: K
authors.lastname: Sunde
authors.affiliation: Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, 4068, Stavanger, Norway. eldar.soreide@sus.no.|Department of Clinical Medicine, University of Bergen, Jonas Lies veg 87, 5021, Bergen, Norway. eldar.soreide@sus.no.
authors.forename: Eldar
authors.initials: E
authors.lastname: Søreide
authors.affiliation: Minneapolis Heart Institute Foundation, Abbot Northwestern Hospital, 920 E 28th Street 100, Minneapolis, MN, 55407, USA. bjunger1@gmail.com.
authors.forename: Barbara T
authors.initials: BT
authors.lastname: Unger
authors.affiliation: Department of Clinical Sciences, Lund University, 22184, Lund, Sweden. hans.a.friberg@gmail.com.|Department of Anaesthesiology and Intensive Care, Skåne University Hospital, Lund, 22185, Sweden. hans.a.friberg@gmail.com.
authors.forename: Hans
authors.initials: H
authors.lastname: Friberg
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D058028:Research Report; D012189:Retrospective Studies; D012727:Sex Characteristics; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome