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Critical Care
Published in: Critical Care 1/2017

Open Access 01-12-2017 | Research

The impact of sex and age on neurological outcomes in out-of-hospital cardiac arrest patients with targeted temperature management

Authors: Sang Hoon Oh, Kyu Nam Park, Jeeyong Lim, Seung Pill Choi, Joo Suk Oh, In Soo Cho, Byung Kook Lee, Yong Hwan Kim, Young-Min Kim, Han Joon Kim, Chun Song Youn, Soo Hyun Kim, On behalf of the Korean Hypothermia Network Investigators

Published in: Critical Care | Issue 1/2017

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Abstract

Background

There are conflicting data regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients, and whether the specific sex advantage is age-specific remains unclear. We assessed the impact of the interactions between sex and age on the neurological outcomes of OHCA patients receiving targeted temperature management (TTM).

Methods

Data collected from 2007 to 2012 for a multicenter, registry-based study of the Korean Hypothermia Network were analyzed. We used a multivariate logistic regression model with an interaction term (age × sex) as the final model for the outcomes. To evaluate the association between sex and outcome in specific age groups, all patients were divided into specific age subgroups, and the adjusted ORs and 95% CIs of good neurological outcomes for males were calculated for each age group. Finally, the ORs of a good neurological outcome for the specific age groups compared with the 50- to 59-year-old group were calculated for both sexes.

Results

In the interaction analysis, age was a negative prognostic factor (OR, 0.95 [95% CI, 0.93-0.98]), whereas sex was not associated with neurological outcomes (OR, 3.74 [95% CI, 0.85–16.35]), and reproductive age in females (age, < 50 years) was also not associated with good neurological outcomes. After the patients were divided into five age groups, sex was not an independent predictor of neurological outcomes across all age groups. Patients of both sexes aged < 40 years had significantly better outcomes than patients in the 50- to 59-year-old group (males, OR, 4.03 [95% CI, 1.86–8.73]; females, OR, 10.34 [95% CI, 1.99–53.85]). Males aged ≥ 70 years had significantly poorer neurological outcomes than those in the 50- to 59-year-old group (OR, 0.15 [95% CI, 0.07–0.32]), but this outcome was not observed for females (OR, 0.78 [95% CI, 0.20–3.14]).

Conclusions

Sex did not influence the neurological outcomes of TTM-treated OHCA patients. In contrast to the outcomes in males, the neurological outcomes of females worsened from 18 to 59 years of age and then remained constant.
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Metadata
Title
The impact of sex and age on neurological outcomes in out-of-hospital cardiac arrest patients with targeted temperature management
Authors
Sang Hoon Oh
Kyu Nam Park
Jeeyong Lim
Seung Pill Choi
Joo Suk Oh
In Soo Cho
Byung Kook Lee
Yong Hwan Kim
Young-Min Kim
Han Joon Kim
Chun Song Youn
Soo Hyun Kim
On behalf of the Korean Hypothermia Network Investigators
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2017
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-017-1860-5

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