Abstract
Background
Prior studies have identified socio-cultural barriers in laypersons performing high-quality
cardiopulmonary resuscitation (CPR) in women. Whether the effect of layperson bystander
CPR on survival from out-of-hospital cardiac arrest (OHCA) differs by patients’ sex
is unknown.
Methods
Using data during 2013–2020 from an OHCA registry in the U.S., we identified adult
patients with non-traumatic OHCA. The primary outcome was favorable neurological survival
and the secondary outcome was survival to discharge. Multivariable logistic regression
models evaluated the interaction between patients’ sex and bystander CPR with survival,
adjusted for patient and cardiac arrest characteristics.
Results
Of 420,671 patients with OHCA, 151,145 (35.9 %) occurred in women and 269,526 (64.1 %)
in men. Rates of layperson bystander CPR were similar between women (38.3 %) and men
(40.0 %). Rates of favorable neurological survival were 11.4 % in those with bystander
CPR and 5.6 % in those without, but the association between bystander CPR and favorable
neurological survival was weaker for women than men (women: adjusted OR, 1.33 [95 %
CI: 1.27–1.39]; men: adjusted OR, 1.55 [95 % CI: 1.51–1.61]; interaction p < 0.001)].
Rates of survival to discharge were 13.1 % and 7.3 % in those with and without layperson
bystander CPR, and the association between bystander CPR was weaker for women than
men (women: adjusted OR, 1.21 [95 % CI: 1.16–1.26]; men: adjusted OR, 1.43 [95 % CI:
1.39–1.47]; interaction p < 0.001).
Conclusions
For OHCA, bystander CPR was associated with higher survival in women and men. However,
as currently practiced, the association between bystander CPR and higher survival
was weaker for women as compared with men.
Keywords
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Article info
Publication history
Published online: September 23, 2022
Accepted:
September 20,
2022
Received in revised form:
September 17,
2022
Received:
June 21,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.