Survival advantage from ventricular fibrillation and pulseless electrical activity in women compared to men: The oregon sudden unexpected death study

Carmen Teodorescu, Kyndaron Reinier, Audrey Uy-Evanado, Jo Ayala, Ronald Mariani, Lynn Wittwer, Karen Gunson, Jonathan Jui, Sumeet S. Chugh

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Objective Studies evaluating a possible survival advantage from sudden cardiac arrest (SCA) in women have produced mixed results possibly due to a lack of comprehensive analyses. We hypothesized that race, socioeconomic status (SES), and elements of the lifetime clinical history influence gender effects and need to be incorporated within analyses of survival. Methods Cases of SCA were identified from the ongoing, prospective, multiple-source Oregon Sudden Unexpected Death Study (population approximately one million). Subjects included were age ≥18 years who underwent attempted resuscitation by EMS providers. Pearson's chi-square tests and independent samples t tests or analysis of variance were used for univariate comparisons. We evaluated gender and race differences in survival adjusted for age, circumstances of arrest, disease burden, and socioeconomic status using a logistic regression model predicting survival. Results A total of 1,296 cases had resuscitation attempted (2002-2007; mean age 65 years, male 67%). Women were older than men (68 vs. 63 years, p<0.0001) and were more likely to have return of spontaneous circulation (41% vs. 33%, p00.004). Women were more likely to present with pulseless electrical activity (PEA) and asystole (p<0.0001), and overall, PEAwas more common among African Americans (p00.04). Higher survival to hospital discharge was observed in women compared to men presenting with ventricular fibrillation/ tachycardia (34% vs. 24%, p00.02) or with PEA (10% vs. 3%, p00.007). In a multivariate model adjusting for age, race, presenting arrhythmia, arrest circumstances, arrest location, disease burden, and SES, women were more likely than men to survive to hospital discharge [odds ratio 1.85; 95% confidence interval (1.12-3.04)]. Conclusions Despite older age, higher prevalence of SCA in the home, and higher rates of PEA, women had a survival advantage from ventricular fibrillation and pulseless electrical activity.

Original languageEnglish (US)
Pages (from-to)219-225
Number of pages7
JournalJournal of Interventional Cardiac Electrophysiology
Volume34
Issue number3
DOIs
StatePublished - Sep 2012

Keywords

  • Pulseless electrical activity
  • Resuscitation
  • Sudden cardiac arrest
  • Survival
  • Ventricular fibrillation
  • Women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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