Sex- and Age-Based Disparities in Public Access Defibrillation, Bystander Cardiopulmonary Resuscitation, and Neurological Outcome in Cardiac Arrest.
JAMA Netw Open
; 6(7): e2321783, 2023 07 03.
Article
em En
| MEDLINE
| ID: mdl-37405772
ABSTRACT
Importance Younger females with out-of-hospital cardiac arrest (OHCA) in public locations have less likelihood to receive public access defibrillation and bystander cardiopulmonary resuscitation (CPR). However, the association between age- and sex-based disparities and neurological outcomes remains underexamined. Objective:
To investigate the association between sex and age and the rate of receiving bystander CPR, automated external defibrillator defibrillation, and neurological outcomes in patients with OHCA. Design, Setting, andParticipants:
This cohort study used the All-Japan Utstein Registry, a prospective, population-based, nationwide database in Japan containing data on 1â¯930â¯273 patients with OHCA between January 1, 2005, and December 31, 2020. The cohort comprised patients with OHCA of cardiac origin that was witnessed by citizens and treated by emergency medical service personnel. The data were analyzed from September 3, 2022, to May 5, 2023. Exposure Sex and age. Main Outcomes andMeasures:
The primary outcome was favorable neurological outcome at 30 days after an OHCA. Favorable neurological outcome was defined as a Cerebral Performance Category score of 1 (indicating good cerebral performance) or 2 (indicating moderate cerebral disability). The secondary outcomes were the rates of receiving public access defibrillation and bystander CPR.Results:
The 354â¯409 included patients who experienced bystander-witnessed OHCA of cardiac origin had a median (IQR) age of 78 (67-86) years and 136â¯520 were females (38.5%). The rate of receiving public access defibrillation was higher in males than females (3.2% vs 1.5%; P < .001). Stratified by age, age- and sex-based disparities in prehospital lifesaving interventions by bystanders and in neurological outcomes were observed. Although younger females had a lower rate of receiving public access defibrillation and bystander CPR than males, younger females had a higher favorable neurological outcome compared with males of the same age (odds ratio [OR], 1.19; 95% CI, 1.08-1.31). In younger females with OHCA that was witnessed by nonfamily bystanders, receiving public access defibrillation (OR, 3.51; 95% CI, 2.34-5.27) or bystander CPR (OR, 1.62; 95% CI, 1.20-2.22) was associated with a favorable neurological outcome. Conclusions and Relevance Results of this study suggest a pattern of significant sex- and age-based differences in bystander CPR, public access defibrillation, and neurological outcomes in Japan. Improvement in neurological outcomes in patients with OHCA, especially younger females, was associated with increased use of public access defibrillation and bystander CPR.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Reanimação Cardiopulmonar
/
Parada Cardíaca Extra-Hospitalar
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
JAMA Netw Open
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Japão