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A more conservative test of sex differences in the treatment and outcome of in-hospital cardiac arrest
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden.ORCID iD: 0000-0003-4772-0067
Linnaeus University, School of Business and Economics, Department of Economics and Statistics.ORCID iD: 0000-0002-5620-4745
Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.ORCID iD: 0000-0001-6134-0058
2023 (English)In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 58, p. 191-197Article in journal (Refereed) Published
Abstract [en]

Background: Studies investigating sex disparities related to treatment and outcome of in-hospital cardiac arrest (IHCA) have produced divergent findings and have typically been unable to adjust for outstanding confounding variables.

Objectives: The aim was to examine sex differences in treatment and survival following IHCA, using a comprehensive set of control variables including e.g., age, comorbidity, and patient-level socioeconomic status. Methods: This retrospective study was based on data from the Swedish Register of Cardiopulmonary Resuscitation and Statistics Sweden. In the primary analyses, logistic regression models and ordinary least square regressions were estimated.

Results: The study included 24,217 patients and the majority (70.4%) were men. In the unadjusted analyses, women had a lower chance of survival after cardiopulmonary resuscitation (CPR) attempt, at hospital discharge (with good neurological function) and at 30 days (p<0.01). In the adjusted regression models, female sex was associated with a higher chance of survival after the CPR attempt (B = 1.09, p<0.01) and at 30-days (B = 1.09, p<0.05). In contrast, there was no significant association between sex and survival to discharge with good neurological outcome. Except for treatment duration (B=-0.07, p<0.01), no significant associations between sex and treatment were identified.

Conclusions: No signs of treatment disparities or discrimination related to sex were identified. However, women had a better chance of surviving IHCA compared to men. The finding that women went from having a survival disadvantage (unadjusted analysis) to a survival advantage (adjusted analysis) attests to the importance of including a comprehensive set of control variables, when examining sex differences.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 58, p. 191-197
National Category
Psychology Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences, Caring Science; Natural Science, Medicine; Social Sciences, Psychology
Identifiers
URN: urn:nbn:se:lnu:diva-117929DOI: 10.1016/j.hrtlng.2022.12.008ISI: 000910624700001PubMedID: 36571977Scopus ID: 2-s2.0-85145726773OAI: oai:DiVA.org:lnu-117929DiVA, id: diva2:1719416
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00256Available from: 2022-12-15 Created: 2022-12-15 Last updated: 2023-02-07Bibliographically approved

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Israelsson, JohanCarlsson, MagnusAgerström, Jens

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