Sex-specific differences and outcome in elderly patients after survived out-of-hospital cardiac arrest
- 14.10.2021
- Originalien
Erschienen in:
- Verfasst von
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Toni Pätz, MD
Korrespondierender Autor Toni Pätz, MD
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 23538, Lübeck, Germany
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Katharina Stelzig
Katharina Stelzig
- Emergency Department, University Hospital of Schleswig-Holstein, Campus Lübeck, 23538, Lübeck, Germany
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Rüdiger Pfeifer
Rüdiger Pfeifer
- Clinic for Internal Medicine, University of Jena, 07747, Jena, Germany
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Holger Thiele
Holger Thiele
- Department of Internal Medicine/Cardiology and Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig, 04289, Leipzig, Germany
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Hans-Jörg Busch
Hans-Jörg Busch
- University Emergency Center, University of Freiburg, 79106, Freiburg, Germany
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Thomas Stiermaier
Thomas Stiermaier
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 23538, Lübeck, Germany
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Ingo Eitel
Ingo Eitel
- University Heart Center Lübeck, Medical Clinic II, Department of Cardiology, Angiology and Intensive Care Medicine, University of Lübeck, German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, 23538, Lübeck, Germany
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Sebastian Wolfrum
Sebastian Wolfrum
- Emergency Department, University Hospital of Schleswig-Holstein, Campus Lübeck, 23538, Lübeck, Germany
Abstract
Background
Little is known about sex differences in elderly patients after out-of-hospital cardiac arrest (OHCA) with return of spontaneous circulation (ROSC) and subsequent target temperature management (TTM). Therefore, this study was designed to evaluate sex-specific differences in survival and neurological outcome in elderly patients at 28-day and 180-day follow-up.
Methods
A total of 468 nontraumatic OHCA survivors with preclinical ROSC and an age of ≥ 65 years were included in this study. Sex-specific differences in survival and a favorable neurological outcome according to the cerebral performance category (CPC) score were evaluated as clinical endpoints.
Results
Of all participants included, 70.7% were men and 29.3% women. Women were significantly older (p = 0.011) and were more likely to have a nonshockable rhythm (p = 0.001) than men. Evaluation of survival rate and favorable neurological outcome by sex category showed no significant differences at 28-day and 180-day follow-up. In multiple stepwise logistic regression analysis, age (odds ratio 0.932 [95% confidence interval 0.891–0.951], p = 0.002) and time of hypoxia (0.899 [0.850–0.951], p < 0.001) proved to be independent predictors of survival only in male patients, whereas an initial shockable rhythm (4.325 [1.309–14.291], p = 0.016) was associated with 180-day survival in female patients. The majority of patients (93.7%) remained in the same CPC category when comparing 28-day and 180-day follow-up.
Conclusion
Our results show no significant sex-specific differences in survival or favorable neurological outcome in elderly patients after having survived OHCA, but sex-specific predictors for 180-day survival. Moreover, the neurological assessment 28 days after the index event also seems to provide a valid indication for the further prognosis in elderly patients.
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- Titel
- Sex-specific differences and outcome in elderly patients after survived out-of-hospital cardiac arrest
- Verfasst von
-
Toni Pätz, MD
Katharina Stelzig
Rüdiger Pfeifer
Holger Thiele
Hans-Jörg Busch
Thomas Stiermaier
Ingo Eitel
Sebastian Wolfrum
- Publikationsdatum
- 14.10.2021
- Verlag
- Springer Medizin
- Erschienen in
-
Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 8/2022
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226 - DOI
- https://doi.org/10.1007/s00063-021-00869-2
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