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Sex-Based Disparities in Receiving Bystander Cardiopulmonary Resuscitation by Location of Cardiac Arrest in Japan

      Abstract

      Objective

      To assess whether sex-based disparities occur by location of arrest in out-of-hospital cardiac arrest (OHCA) victims receiving bystander cardiopulmonary resuscitation (BCPR).

      Patients and Methods

      This secondary analysis of the All-Japan Utstein Registry included patients 18 years and older with OHCA of medical origin in public or residential locations, witnessed by bystanders, from January 1, 2013, through December 31, 2015. We assessed the likelihood of receiving BCPR based on sex differences and by arrest location. Sex-based disparities in receiving BCPR stratified by age and location were assessed via multivariable logistic regression analyses.

      Results

      During the study period, 373,359 OHCAs were registered, and 84,734 were eligible for analysis. Overall, 54.2% of women (3123 of 5766) and 57.0% of men (8672 of 15,213) received BCPR in public locations (P<.001), and 46.5% of women (11,263 of 24,216) and 44.0% of men (17,390 of 39,539) received BCPR in residential locations (P<.001). In the multivariable logistic regression analyses, there was no significant difference between the sexes in terms of who received BCPR in public locations (adjusted odds ratio [AOR], 0.99; 95% CI, 0.92-1.06), and women had a higher likelihood of receiving BCPR in residential locations (AOR, 1.08; 95% CI, 1.04-1.13). In public locations, women aged 18 to 64 years were less likely to receive BCPR (AOR, 0.86; 95% CI, 0.74-0.99), and when witnessed by a non–family member, women were less likely to receive BCPR regardless of age group.

      Conclusion

      The reasons for this sex-based disparity should be better understood to facilitate public health interventions.

      Abbreviations and Acronyms:

      AED (automated external defibrillator), AOR (adjusted odds ratio), BCPR (bystander cardiopulmonary resuscitation), CPC (cerebral performance category), CPR (cardiopulmonary resuscitation), EMS (emergency medical services), FDMA (Fire and Disaster Management Agency), OHCA (out-of-hospital cardiac arrest), OR (odds ratio), PEA (pulseless electrical activity), VF (ventricular fibrillation), VT (pulseless ventricular tachycardia)
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