Sex differences in the association of comorbidity with shockable initial rhythm in out-of-hospital cardiac arrest

• Published in: Resuscitation 2021-10, Vol.167, p.173-179
• Main Authors: van Dongen, Laura H., Oving, Iris, Dijkema, Pauline W., Beesems, Stefanie G., Blom, Marieke T., Tan, Hanno L.
• Format: Article
• Language: English
• Subjects: Cumulative comorbidity; ESCAPE-NET; Out-of-hospital cardiac arrest; Sex differences; Shockable initial rhythm
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2021.08.034

Lower survival chances after out-of-hospital cardiac arrest (OHCA) in women is associated with lower odds of a shockable initial rhythm (SIR). We hypothesized that sex differences in the prevalence of SIR are due to sex differences in comorbidities. We aimed to establish to what extent sex differences in the cumulative comorbidity burden, measured using the Charlson Comorbidity Index (CCI), or in individual comorbidities, account for the lower proportion of SIR in women. The association between CCI or its constituent comorbidities, and presence of SIR was studied using data (2010–2014) from a Dutch community-based OHCA registry, and included 2510 OHCA patients aged ≥18y with presumed cardiac cause. The mean age was 67.8 ± 13.8y, 71% were men. Women were more often in high CCI categories than men. However, moderate or high disease burden was associated with lower odds of SIR compared to no disease burden only in men (OR 99 %CI 0.73 [0.53–1.00] and OR 0.54 [0.37–0.80] P-trend