title: Sex-Based Disparities in Incidence, Treatment, and Outcomes of Cardiac Arrest in the United States, 2003-2012.
abstract: Recent studies have shown improving survival after cardiac arrest. However, data regarding sex-based disparities in treatment and outcomes after cardiac arrest are limited.
  
  
  
  We performed a retrospective analysis of all patients suffering cardiac arrest between 2003 and 2012 using the Nationwide Inpatient Sample database. Annual rates of cardiac arrest, rates of utilization of coronary angiography/percutaneous coronary interventions/targeted temperature management, and sex-based outcomes after cardiac arrest were examined. Among a total of 1 436 052 discharge records analyzed for cardiac arrest patients, 45.4% (n=651 745) were females. Women were less likely to present with ventricular tachycardia/ventricular fibrillation arrests compared with men throughout the study period. The annual rates of cardiac arrests have increased from 2003 to 2012 by 14.0% (Ptrend<0.001) and ventricular tachycardia/ventricular fibrillation arrests have increased by 25.9% (Ptrend<0.001). Women were less likely to undergo coronary angiography, percutaneous coronary interventions, or targeted temperature management in both ventricular tachycardia/ventricular fibrillation and pulseless electrical activity/asystole arrests. Over a 10-year study period, there was a significant decrease in in-hospital mortality in women (from 69.1% to 60.9%, Ptrend<0.001) and men (from 67.2% to 58.6%, Ptrend<0.001) after cardiac arrest. In-hospital mortality was significantly higher in women compared with men (64.0% versus 61.4%; adjusted odds ratio 1.02, P<0.001), particularly in the ventricular tachycardia/ventricular fibrillation arrest cohort (49.4% versus 45.6%; adjusted odds ratio 1.11, P<0.001).
  
  
  
  Women presenting with cardiac arrests are less likely to undergo therapeutic procedures, including coronary angiography, percutaneous coronary interventions, and targeted temperature management. Despite trends in improving survival after cardiac arrest over 10 years, women continue to have higher in-hospital mortality when compared with men.
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY luk9003@med.cornell.edu.
authors.forename: Luke K
authors.initials: LK
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Patrick
authors.initials: P
authors.lastname: Looser
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Rajesh V
authors.initials: RV
authors.lastname: Swaminathan
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: James
authors.initials: J
authors.lastname: Horowitz
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Oren
authors.initials: O
authors.lastname: Friedman
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Ji Hae
authors.initials: JH
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Minutello
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Bergman
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Harsimran
authors.initials: H
authors.lastname: Singh
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: S Chiu
authors.initials: SC
authors.lastname: Wong
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY.
authors.forename: Dmitriy N
authors.initials: DN
authors.lastname: Feldman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D054624:Health Status Disparities; D006323:Heart Arrest / Q000453:epidemiology / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: angiography; heart arrest; revascularization; sudden death; women