Temporal trends in out-of-hospital cardiac arrest outcomes in men and women from 2008 to 2015: A national observational study

초록

Background We compared the temporal trends in survival and neurological outcomes after out-of-hospital cardiac arrest (OHCA) in men and women. Methods A nationwide, population-based observational study enrolled adults with OHCA of presumed cardiac origin from 2008 to 2015. The main outcomes were survival and neurological recovery. We performed trend analyses of potential risk factors and outcomes. Adjusted odd ratios (aOR) were calculated using multivariate logistic regression analysis after adjusting for confounders. To assess whether outcomes had improved over time in both sexes, we calculated the yearly risk-adjusted survival rates and neurological recovery rate for the study period. Results We included 121,900 patients in the final analysis. Women comprised 36.2% of the patients. During the study, survival improved in both sexes, from 3.2% to 7.9% in men and from 1.8% to 3.7% in women. Neurological recovery improved in men from 1.1% to 5.9% and in women from 0.7% to 2.3%. The risk-adjusted survival rates increased significantly in men from 3.2% in 2008 to 5.7% in 2015 (p for trend <0.01); these rates did not increase to the same degree in women (from 1.8% in 2008 to 3.4% in 2015; p for trend <0.01). After adjusting for confounders, the risk-adjusted neurological recovery rate increased from 1.1% in 2008 to 4.3% in 2015 (p for trend <0.01) in men. This improvement trend was lower in women (from 0.7% in 2008 to 1.5% in 2015, p for trend <0.01). Conclusions The outcomes of OHCA improved in both sexes during the study period. The degree of improvement in outcomes was higher in men than in women.