Sex-related differences in the association of obesity described by emergency medical teams on outcomes in out-of-hospital cardiac arrest patients.

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Clinical and Experimental Medicine Pub Date : 2024-11-07 DOI:10.17219/acem/193367
Vicente Doménech Briz, Raúl Juárez-Vela, Łukasz Lewandowski, Grzegorz Kubielas, Jacek Smereka, Vicente Gea-Caballero, Antonio Martínez-Sabater, Michał Czapla
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Abstract

Background: Out-of-hospital cardiac arrests (OHCA) are a major global health concern, occurring frequently worldwide. Obesity may impact outcomes in OHCA patients.

Objectives: This study aimed to assess the impact of obesity on the return of spontaneous circulation (ROSC) in OHCA patients, considering sex differences.

Material and methods: A retrospective cohort study was conducted, analyzing medical records of patients assisted by the Emergency Medical System (EMS) in Poland from January 2021 to June 2022. The study included 33,636 patients with OHCA. Obesity status was determined using ICD-10 codes (E66) and descriptive diagnoses recorded by EMS teams.

Results: Univariate analysis indicated that obesity decreased the odds of ROSC by 25.47% (odds ratio (OR) = 0.75, 95% confidence interval (95% CI): 0.61-0.92) in women and by 19.76% (OR = 0.80, 95% CI: 0.66-0.97) in men. However, multivariate analysis, adjusting for confounding variables, did not confirm a statistically significant impact of obesity on ROSC outcomes. The likelihood of ROSC was significantly higher in individuals with an initial ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) rhythm compared to Asystole/pulseless electrical activity (PEA), being 4.204 times higher in women (95% CI: 3.525-5.014) and 3.655 times in men (95% CI: 3.320-4.023). Out-of-hospital cardiac arrest in a public place increased the odds of ROSC more than twofold for both sexes (women: OR = 2.20, 95% CI: 2.00-2.43; men: OR = 2.13, 95% CI: 1.98-2.29). Among women without obesity, hypertension decreased the odds of ROSC by 11.11% (OR = 0.89, 95% CI: 0.81-0.99).

Conclusions: Our study demonstrated that obesity was not an independent predictor of ROSC in OHCA patients. Different predictors of ROSC were identified for men and women. Initial VF/pVT rhythm, location of OHCA and age were the significant factors influencing ROSC.

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急救医疗小组描述的肥胖与院外心脏骤停患者预后的性别差异。
背景:院外心脏骤停(OHCA)是全球关注的一个主要健康问题,在世界各地频繁发生。肥胖可能会影响院外心脏骤停患者的预后:本研究旨在评估肥胖对 OHCA 患者自发性循环恢复(ROSC)的影响,同时考虑性别差异:研究对 2021 年 1 月至 2022 年 6 月期间波兰急救医疗系统(EMS)救助的患者病历进行了回顾性队列研究分析。研究包括 33636 名 OHCA 患者。肥胖状况是根据ICD-10编码(E66)和急救医疗小组记录的描述性诊断确定的:单变量分析表明,肥胖使女性 ROSC 的几率降低了 25.47%(几率比 (OR) = 0.75,95% 置信区间 (95% CI):0.61-0.92),使男性 ROSC 的几率降低了 19.76%(OR = 0.80,95% CI:0.66-0.97)。然而,在对混杂变量进行调整后进行的多变量分析并未证实肥胖对 ROSC 结果有显著的统计学影响。初始心室颤动(VF)或无脉室性心动过速(pVT)心律的患者获得ROSC的可能性明显高于心室收缩/无脉电活动(PEA)患者,女性是男性的4.204倍(95% CI:3.525-5.014),男性是女性的3.655倍(95% CI:3.320-4.023)。在公共场所发生的院外心脏骤停使男女患者的 ROSC 机率增加了两倍多(女性:OR = 2.20,95% CI:2.00-2.43;男性:OR = 2.13,95% CI:1.98-2.29)。在没有肥胖症的女性中,高血压会使ROSC几率降低11.11%(OR = 0.89,95% CI:0.81-0.99):我们的研究表明,肥胖并不是预测 OHCA 患者 ROSC 的独立因素。男性和女性的 ROSC 预测指标有所不同。初始 VF/pVT 节律、OHCA 的位置和年龄是影响 ROSC 的重要因素。
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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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