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CPR | Women less likely to receive procedures for cardiac arrest

Women cardiac arrest patients are less likely than men to receive potentially lifesaving procedures to look for and open blocked coronary arteries, according to new research in Journal of the American Heart Association.

Procedures such as angiography and angioplasty help boost cardiac arrest survival rates, but women “tend to get less immediate care when time is essential,” said Luke Kim, M.D., study lead author and assistant professor of medicine in the cardiology division of Weill Cornell Medical College in New York.

The study is the first on sex-based disparities across a representative spectrum of cardiac arrest patients.

Cardiac arrest occurs when the heart abruptly stops functioning due to malfunction of its electrical system. In 2014, about 356,500 people in the United States suffered out-of-hospital cardiac arrests; only 12 percent of those treated by emergency medical services survived.

During the 10-year study involving more than 1,000 U.S. hospitals nationally, death rates fell for both sexes. But 64 percent of women treated for cardiac arrest in the hospital died compared to 61 percent of men.

Using a database of hospital discharge records known as the Nationwide Inpatient Sample, researchers analyzed more than 1.4 million cases in which cardiac arrest patients were transported alive to acute-care hospitals in 2003-12. During that time, the number of cardiac arrests increased by 14 percent.

Adjusting for factors including patient age, health, hospital characteristics and previous cardiac procedures, researchers also found that women who had a cardiac arrest from a shockable rhythm were:

  • 25 percent less likely to receive coronary angiography.

  • 29 percent less likely to have angioplasty, also known as percutaneous coronary intervention.

  • 19 percent less likely to be treated with therapeutic hypothermia, in which body temperature is lowered to help improve odds of survival and reduce risk of brain damage.

In the study, women were older than men and less likely to have been previously diagnosed with coronary artery disease. They were more likely to have other health problems, such as congestive heart failure, high blood pressure, obesity and other issues, and to have cardiac arrest caused by problems other than a blood vessel blockage, such as pulmonary embolism.

More people taught about cardiac arrest, how to perform CPR and how to use defibrillators could improve survival rates, Kim said.

Unlike some of the other disorders, “cardiac arrest is one of the few medical emergencies where there’s a huge impact due to how the public responds to it,” Kim said. “If someone can get to a patient right away and do CPR, that patient has a chance.”



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