To assess whether bystander cardiopulmonary resuscitation (CPR) differed by patient sex among bystander-witnessed out-of-hospital cardiac arrests (OHCA). This study is a retrospective analysis of paramedic-attended OHCA in New South Wales (NSW) between January 2017 to December 2019 (restricted to bystander-witnessed cases). Exclusions included OHCA in aged care, medical facilities, with advance care directives, from non-medical causes. Multivariate logistic regression examined the association of patient sex with bystander CPR. Secondary outcomes were OHCA recognition, bystander AED application, initial shockable rhythm, and survival outcomes. Of 4,491cases, females were less likely to receive bystander CPR in private residential (Adjusted Odds ratio [AOR]: 0.82, 95%CI: 0.70–0.95) and public locations (AOR: 0.58, 95%CI:0.39–0.88). OHCA recognition during the emergency call was lower for females arresting in public locations (84.6% vs 91.6%, = 0.002) and this partially explained the association of sex with bystander CPR (∼44%). This difference in recognition was not observed in private residential locations ( = 0.2). Bystander AED use was lower for females (4.8% vs 9.6%, < 0.001); however, after adjustment for location and other covariates, this relationship was no longer significant (AOR: 0.83, 95%CI: 0.60–1.12). Females were less likely to be in an initial shockable rhythm (AOR: 0.52, 95%CI: 0.44–0.61), but more likely to survive the event (AOR: 1.34, 95%CI: 1.15–1.56). There was no sex difference in survival to hospital discharge (AOR: 0.96, 95%CI: 0.77–1.19). OHCA recognition and bystander CPR differ by patient sex in NSW. Research is needed to understand why this difference occurs and to raise public awareness of this issue.

中文翻译：

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旁观者心肺复苏的性别差异——逮捕识别的作用


旨在评估在旁观者目击的院外心脏骤停 (OHCA) 中，旁观者心肺复苏 (CPR) 是否因患者性别而异。本研究对 2017 年 1 月至 2019 年 12 月期间新南威尔士州 (NSW) 护理人员就诊的 OHCA 进行回顾性分析（仅限于旁观者目击病例）。排除范围包括老年护理、医疗设施中的 OHCA（有预先护理指示）、非医疗原因导致的 OHCA。多变量逻辑回归检查了患者性别与旁观者心肺复苏的关联。次要结果是 OHCA 识别、旁观者 AED 应用、初始可电击节律和生存结果。在 4,491 例病例中，女性在私人住宅（调整后优势比 [AOR]：0.82，95%CI：0.70–0.95）和公共场所（AOR：0.58，95%CI：0.39–0.88）接受旁观者心肺复苏的可能性较小。对于在公共场所逮捕的女性，OHCA 在紧急呼叫期间的识别率较低（84.6% vs 91.6%，= 0.002），这部分解释了性别与旁观者心肺复苏的关联（∼44%）。在私人住宅区没有观察到这种认知差异 ( = 0.2)。女性旁观者 AED 使用率较低（4.8% vs 9.6%，< 0.001）；然而，在调整位置和其他协变量后，这种关系不再显着（AOR：0.83，95％CI：0.60-1.12）。女性不太可能处于初始可电击节律（AOR：0.52，95％CI：0.44-0.61），但更有可能在事件中幸存（AOR：1.34，95％CI：1.15-1.56）。出院生存率没有性别差异（AOR：0.96，95%CI：0.77-1.19）。新南威尔士州的 OHCA 认可和旁观者心肺复苏因患者性别而异。需要进行研究来了解为什么会出现这种差异，并提高公众对此问题的认识。