Abstract 4144485: Gender Disparities in In-Hospital Outcomes After Out-of-Hospital Cardiac Arrest: Insight from the United States National Inpatient Sample

Background: Out-of-hospital cardiac arrest (OHCA) is a critical emergency with a high mortality rate, necessitating immediate intensive medical intervention, which may include advanced therapies such as mechanical circulatory support (MCS). Despite advances and organized protocols, outcomes remain poor due to various factors, including gender. While gender disparities in cardiovascular health well-documented, their impact on OHCA outcomes, particularly in-hospital mortality and MCS use, remains unclear. This study investigates these disparities using the 2019-2020 National Inpatient Sample database, aiming to identify gender differences in outcomes and improve management of OHCA patients. Methods: We conducted a retrospective cohort study based on the 2019-2020 NIS database of the Healthcare Utilization Project. Our population included patients 18 years or older with OHCA as the primary diagnosis, identified using ICD-10 codes. The primary risk factors examined was gender, classified into male and female. The primary outcome was in-hospital mortality among patients with OHCA. The secondary outcome was mechanical circulatory support (MCS) use. Left ventricular assist device (LVAD), extracorporeal membrane oxygenation (ECMO), and intra-aortic balloon pump (IABP) were identified as MCS. Multivariate regression analysis was used to estimate the odds ratio. Results: During the study period, 26,640 hospitalizations with OHCA were identified, of whom 57.1% were male. The mean (SD) age of patients with OHCA was 65.2 (16) years old, and male patients had lower mean age compared to female patients (64.6 vs 66 years old, p<0.001). A total of 19,425 died (72.9%) and 0.9% needed MCS. Notably, more females died compared to male subset (74.6 vs 71.7%, p<0.001). Although not significant, MCS use was 1.1% in males and 0.67% in females. In the multivariate analysis, we did not find statistical significance among genders regarding in-hospital mortality and MCS use. Conclusion: Our findings reveal a higher in-hospital mortality rate among female patients following OHCA. However, the multivariate analysis did not show statistically significant gender differences regarding in-hospital mortality or the use of MCS. This suggests that factors other than gender are critical in determining these outcomes. Further research is essential to identify these factors and develop targeted interventions to enhance survival rates for all OHCA patients.