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Men received automated external defibrillator (AED) use more often before Emergency Medical Services (EMS) arrival for out-of-hospital cardiac arrest (OHCA). Women experienced longer delays in initial EMS defibrillation, highlighting gender-based disparities in OHCA care.

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Area of Science:

  • Emergency Medicine
  • Cardiology
  • Public Health

Background:

  • Significant survival disparities persist for women experiencing out-of-hospital cardiac arrest (OHCA) compared to men.
  • Understanding pre-hospital care differences, specifically automated external defibrillator (AED) use and defibrillation timing, is crucial for improving outcomes.

Purpose of the Study:

  • To evaluate gender-based differences in AED application prior to Emergency Medical Services (EMS) arrival.
  • To assess disparities in the time from EMS arrival to initial defibrillation for men versus women with OHCA.

Main Methods:

  • Secondary analysis of adult, non-traumatic OHCA cases from the Portland Cardiac Arrest Epidemiologic Registry (2018-2021).
  • Examined pre-EMS AED application rates (overall, law enforcement, lay responders) and time to first EMS defibrillation.
  • Used multivariable logistic and linear regressions, adjusting for confounders and accounting for county-level clustering.

Main Results:

  • Men had significantly higher adjusted odds of pre-EMS AED placement compared to women (aOR 1.40).
  • This disparity favored men for law enforcement AED application (aOR 1.89) but not lay bystander AED application (aOR 1.19).
  • Among patients requiring defibrillation, women faced a significantly longer time from EMS arrival to initial defibrillation (+0.81 min).

Conclusions:

  • Women with OHCA received lower rates of pre-EMS AED application compared to men.
  • Delays in initial EMS defibrillation were observed for women, indicating gender-based disparities in critical care.
  • Addressing these disparities is essential for improving survival outcomes for women after OHCA.