Associazione Nazionale Medici Cardiologi Ospedalieri




Carinci Valeria Bologna(Bologna) – UOC Cardiologia O. Maggiore | Cardelli Laura Bologna(Bologna) – UOC Cardiologia O. Maggiore | Gamberini Lorenzo Bologna(Bologna) – Anestesia-Rianimazione 118 O. Maggiore

Bakground: It is a well known fact that men (M) are more likely to suffer of out of hospital cardiac arrest (OHCA) than women (W). Women account for 20-40 % of all OHCA, probably due to a minor prevalence of coronaric disease.

Methods: Our retrospective study considered all OHCA occurred in the Bologna metropolitan area (456.200 inhabitants) between 2009 and 2019. We considered all Pts, admitted alive at the hospital, presenting a NON STEMI ECG or a nondiagnostic ECG. We excluded Pts with STEMI ECG and extra cardiac causes of cardiac arrest or missing follow up. For each patient demographic informations, initial cardiac rhythm (ventricular fibrillation/ventricular tachycardia (VF/VT), asystole, or pulseless acticity (PEA)) and in hospital mortality, have been collected

Results: We evaluated 2072 OHCA, 1394 m (67%, age 66±13 yrs) and 678 w (33%, age 72±17 yrs, 0.04). The prevalent initial rhythm was VF/VT in m (38% m vs 19% w), and PEA in w (35% m vs 49% w). Survival at hospital discharge has been 13,8% in m and 11,5% w

We analyzed data of 146 pts presenting with non STEMI ECG or non diagnostic ECG: 46 w (31,5%) and 100 m (68,5%). Mean age was 60±18 yrs in w and 62 ±17 yrs in m (p = 0,552). The initial rhythm was VF/VT in 54,5% of w and 75,5% of m (p = 0,01), PEA in 25% w and 16,5% m (p = 0,192) and asystole in 20,5% w and 8,5% m (p = 0.054)

30 over 46 w (65%) underwent a coronaric study against 83 m over 100 (83%) (p = 0,021); between these pts, 6 w (13,6%) underwent percutaneous angioplasty against 30 m (30,0%) (p = 0,037). In the pts underwent to invasive study, mortality has been 40% for the w and 23% for the m (p = 0,095). In the conservative arm mortality was 62,5% for the w and 47% for the m (p = 0,49). Total mortality has been 47,8% for the w and 27 % for the m (p = 0,015)

A multiparametric analysis matching mortality versus age, sex, initial rhythm VF/VT and witnessed cardiac arrest (Tab 1) showed that male sex has been indipendently associated to lower mortality OR 0.37 (95% CI 0.16 – 0.86).

Conclusions: In the Bologna metropolitan area, women represent 37% of OHCA. In the group of pts without ST elevation ECG, women represent equally only 31%, but show mean age and prevalence of initial rhythm VF/VT similar to men. Men and women had different access to coronaric study and present different mortality rate. This topic of research has great scientific relevance and its results deserve further studies to investigate the differences pointed out