Abstract
Aim
We investigated the impact of premenopausal age on neurological function at hospital
discharge in patients with out-of-hospital cardiac arrest (OHCA). We hypothesized
that premenopausal-aged females (18–47 years of age) with OHCA would have a higher
probability of survival with favourable neurological function at hospital discharge
compared with males of the same age group, older males, and older females (>53 years
of age).
Methods
Retrospective analyses of data from the Resuscitation Outcomes Consortium multi-center
randomized controlled trial (June 2011–May 2015). We included adults with non-traumatic
OHCA treated by emergency medical service. We stratified the cohort into four groups
by age and sex: premenopausal-aged females (18–47 years of age), older females (≥53 years
old), younger males (18–47 years of age), and older male. We used multilevel logistic
regression to examine the association between age-sex and favourable neurological
outcomes (modified Rankin Scale ≤ 3).
Results
In total, 23,725 patients were included: 1050 (4.5%) premenopausal females; 1930 (8.1%)
younger males; 7569 (31.9%) older females; and 13,176 (55.5%) older males. The multilevel
analysis showed no difference in neurological outcome between younger males and younger
females (OR 0.95, 95% CI 0.69–1.32, p = 0.75). Both older females (OR 0.36, 95% CI
0. 0.26–0.48, p < 0.001) and older males (OR 0.52, 95% CI 0.39–0.69, p < 0.001) had
a significantly lower odds of favourable neurological outcome than younger females.
Among all groups, older females had the worst outcomes.
Conclusions
We did not detect an association between premenopausal age and survival with good
neurological outcome, suggesting females sex hormones do not impact OHCA outcomes.
Our findings are not in line with results from other studies. Studies that rigorously
evaluate menopausal status are required to definitively assess the impact of female
sex hormones on outcomes.
Keywords
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Article info
Publication history
Published online: July 13, 2021
Accepted:
June 20,
2021
Received in revised form:
May 14,
2021
Received:
March 7,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
