Abstract 131: Sex-Based Differences in the Extracorporeal Cardiopulmonary Resuscitation Population for Out-of-Hospital Cardiac Arrest in the Minneapolis Metro Area
Abstract only Background: Women constitute nearly 40% of out-of-hospital cardiac arrests (OHCA), receive less bystander CPR, and guideline-directed interventions such as post-arrest coronary angiography. Aims: To identify the presence of sex-based differences in utilization of extracorporeal cardiop...
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| Published in: | Circulation (New York, N.Y.) Vol. 148; no. Suppl_1 |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
07-11-2023
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| Online Access: | Get full text |
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| Summary: | Abstract only
Background:
Women constitute nearly 40% of out-of-hospital cardiac arrests (OHCA), receive less bystander CPR, and guideline-directed interventions such as post-arrest coronary angiography.
Aims:
To identify the presence of sex-based differences in utilization of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory OHCA in the Minneapolis (MSP) metro area.
Methods:
Patients who met all eligibility criteria for the Minnesota Resuscitation Consortium (MRC) ECPR protocol between 2013-2021 were identified in the Cardiac Arrest Registry to Enhance Survival (CARES) registry. Patients who presented to the University of Minnesota (UMN) for the MRC ECPR protocol between 2014-2021 were identified. Arrest data, patient characteristics and mortality were compared between the sexes in both populations.
Results:
We identified 2790 OHCA patients through the CARES registry of whom 685 (24.6%) were women. There were 443 referrals to UMN for ECPR, of whom 87 (19.6%) were women. There were significantly more eligible women who arrested than those referred for ECPR (p =0.02). In the MSP metro area, women were more likely to suffer cardiac arrest at home (59% vs 66%, p<0.01), less likely to receive bystander CPR (42% vs 35%, p<0.01) and have greater time to professional CPR (6.3 vs 5.4 minutes, p<0.01). Among referrals for MRC ECPR protocol, there were no differences in arrest characteristics or age between men and women. Multivariate analysis for neurologically favorable survival showed female sex was associated with decreased survival in the community (p=0.03), but trended towards increased survival in the UMN ECPR cohort (p=0.08) (Figure 1).
Conclusion:
Women suffering from cardiac arrest have higher mortality and are less likely to be referred for ECPR. However, after referral for ECPR, sex is not associated with survival. Pre-hospital factors result in fewer women referred for ECPR and warrant further investigation to identify potential interventions. |
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| ISSN: | 0009-7322 1524-4539 |
| DOI: | 10.1161/circ.148.suppl_1.131 |