Abstract Sun602: Lower Survival After Out-of-Hospital Cardiac Arrest in Older Females: The Joint Effect of Age and Sex
Bibliographic record
Abstract
Background: Sex-based differences in survival following out-of-hospital cardiac arrest (OHCA) have been widely studied, but the joint effect of age and sex remains unclear. Aims: To examine the joint effect of age and sex on OHCA outcomes, hypothesizing that older females have lower rates of return of spontaneous circulation (ROSC) and survival to hospital discharge. Methods: We conducted a retrospective analysis of prospectively collected data from the British Columbia (BC) site of the Resuscitation Outcomes Consortium (ROC) Cardiac Arrest registry (2011–2016). EMS-treated adult OHCA patients were included; traumatic arrests and DNR cases were excluded. Patients were stratified into four age-sex groups: younger females (18–47 years), younger males (18–47), older females (≥53), and older males (≥53). To reduce misclassification bias, we excluded 833 patients aged 48–52. Multivariable logistic regression assessed differences in ROSC and survival between groups, using younger females as the reference and adjusting for Utstein predictors. Results: A total of 6,454 cases were included in the analysis. Older females had the lowest rates of public location arrests (7.1%) and shockable rhythms (12.4%). Crude ROSC rate was lowest in older females (33.9%) compared to other groups: older males (35.4%), younger males (38.7%), and younger females (38.9%) (p = 0.33). Crude survival to hospital discharge differed significantly across groups, with older females having the lowest survival rate (6.1%) (p < 0.001) (Table 1). After adjusting for Utstein predictors, the odds of ROSC were significantly lower in younger males (OR 0.76, p = 0.01), older females (OR 0.75, p = 0.006), and older males (OR 0.63, p < 0.001), compared to younger females (reference group). For survival to hospital discharge, older females had the lowest odds (OR 0.30, p < 0.001), followed by older males (OR 0.42, p < 0.001). The odds of survival in younger males did not differ significantly from younger females (OR 1.02, p = 0.87) (Table 2). Conclusion: Older females exhibited the lowest rates of ROSC and survival to hospital discharge. Adjusted analysis confirmed significantly lower odds of both outcomes in this group. The lower prevalence of shockable rhythms among older females may partially explain these disparities; however, further investigation is warranted to identify additional factors contributing to these disparities in outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".