title: Effect of gender on outcome of out of hospital cardiac arrest in the Resuscitation Outcomes Consortium.
abstract: BACKGROUND
  This study examined the relationship between gender and outcomes of non-traumatic out-of-hospital cardiac arrest (OHCA).
  
  
  METHODS
  All eligible, consecutive, non-traumatic Emergency Medical Services (EMS) treated OHCA patients in the Resuscitation Outcomes Consortium between December 2005 and May 2007. Patient age was analyzed as a continuous variable and stratified in two age cohorts: 15-45 and >55 years of age (yoa). Unadjusted and adjusted (based on Utstein characteristics) chi square tests and logistic regression models were employed to examine the relationship between gender, age, and survival outcomes.
  
  
  RESULTS
  This study enrolled 14,690 patients: of which 36.4% were women with a mean age of 68.3 and 63.6% of them men with a mean age of 64.2. Women survived to hospital discharge less often than men (6.4% vs. 9.1%, p<0.001); the unadjusted OR was 0.69, 95%CI: 0.60, 0.77 whereas when adjusted for all Utstein predictors the difference was not significant (OR: 1.16, 95%CI: 0.98, 1.36, p=0.07). The adjusted survival rate for younger women (15-45 yoa) was 11.1% vs. 9.8% for younger men (OR: 1.66, 95%CI: 1.04, 2.64, p=0.03) but no difference in discharge rates was observed in the >55 cohort (OR: 0.94, 95%CI: 0.78, 1.15, p=0.57).
  
  
  CONCLUSIONS
  Women who suffer OHCAs have lower rates of survival and have unfavourable Utstein predictors. When survival is adjusted for these predictors survival is similar between men and women except in younger women suggesting that age modifies the association of gender and survival from OHCA; a result that supports a protective hormonal effect among premenopausal women.
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada; Division of Emergency Medicine; Department of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address: morrisonl@smh.ca.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Morrison
authors.affiliation: Clinical Trials Centre, University of Washington, WA, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Schmicker
authors.affiliation: Johns Hopkins Medicine, Baltimore, MD, USA.
authors.forename: Myron L
authors.initials: ML
authors.lastname: Weisfeldt
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Blair L
authors.initials: BL
authors.lastname: Bigham
authors.affiliation: The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.affiliation: The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Topjian
authors.affiliation: Cardiac Prevention Centre & Women's Cardiovascular Health, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
authors.forename: Beth L
authors.initials: BL
authors.lastname: Abramson
authors.affiliation: University of Iowa Children's Hospital, Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Dianne L
authors.initials: DL
authors.lastname: Atkins
authors.affiliation: Division of Cardiovascular Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Debra
authors.initials: D
authors.lastname: Egan
authors.affiliation: Division of Cardiovascular Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: George
authors.initials: G
authors.lastname: Sopko
authors.affiliation: Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada; Toronto Health Economics and Technology Assessment Collaborative, Toronto General Research Insitute, University Health Network, and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
authors.forename: Valeria E
authors.initials: VE
authors.lastname: Rac
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000706:statistics & numerical data; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009656:North America; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D010351:Patient Discharge / Q000706:statistics & numerical data; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adult population; Cardiopulmonary resuscitation; Gender; Heart arrest; Out of hospital cardiac arrest