Survival of in-hospital cardiac arrest in men and women in a large Swedish cohort

BACKGROUND: Cardiac arrest is more common in men than women and a few studies have shown inferior 30-day survival for men than for women. The difference might relate to patient characteristics, intra arrest factors or post arrest care. AIM: To assess differences in 30-day survival between men and women after an in-hospital cardiac arrest (IHCA). MATERIAL AND METHODS: All patients ≥18 years suffering an IHCA at Karolinska University Hospital between 2007 and 2017 were included. Data regarding the IHCA, patient characteristics, Charlson co-morbidity index (CCI) and 30-day survival were obtained from electronic patient records. Differences in survival between men and women were assessed with adjusted logistic regression models and presented as Odds Ratios with 95% Confidence Intervals (OR, 95% CI). Adjustments included age, CCI, place of cardiac arrest, first rhythm, ECG-surveillance and witnessed or not. RESULTS: In all, 1639 patients suffered an IHCA, of whom 650 (40%) were women and 193 (30%) of them survived to 30 days compared to 28% of the men. No differences were found in the studied patient characteristics, intra arrest factors or post-ROSC treatments. Men had similar survival as women (crude OR 0.93 95% CI 0.74-1.15 and adjusted OR 0.77 95% CI 0.58-1.03 respectively). CONCLUSION: This cohort study illuminates an almost equal distribution in characteristics and treatment as well as outcome, 30-day survival after IHCA between men and women. However, our study confirms previous findings of disadvantageous prerequisites among women, but also indicates that preceeding vital signs differ which might indicate residual confounding.