Evidence map›Paper›PMID 39478597›Full record

ArticleCritical care (London, England)2024

Sex differences in extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: nationwide multicenter retrospective study in Japan.

Akira Kawauchi, Yohei Okada, Makoto Aoki, Akihiko Inoue, Toru Hifumi, Tetsuya Sakamoto, Yasuhiro Kuroda, Mitsunobu Nakamura, SAVE-J II Study Group

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. Observational
  6. Article
  7. Mechanism of post cardiac arrest syndrome based on animal models of cardiac arrest.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Akira KawauchiDepartment of Critical Care and Emergency Medicine, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan. a.kawauchi622@gmail.com.
Yohei OkadaHealth Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Makoto AokiDivision of Traumatology, Research Institute, National Defense Medical College, Saitama, Japan.
Akihiko InoueDepartment of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, Japan.
Toru HifumiDepartment of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan.
Tetsuya SakamotoDepartment of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Yasuhiro KurodaDepartment of Emergency, Disaster and Critical Care Medicine, Kagawa University Hospital, Kagawa, Japan.
Mitsunobu NakamuraDepartment of Critical Care and Emergency Medicine, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan.
SAVE-J II Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious studies examining sex differences in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) have indicated that women have favorable outcomes; however, detailed evidence remains lacking. We aimed to investigate sex differences in the backgrounds and outcomes of patients undergoing ECPR for OHCA.

methodsThis study was a secondary analysis of the registry from the SAVE-J II study, a retrospective multicenter study conducted in Japan from 2013 to 2018. Adult patients without external causes who underwent ECPR for OHCA were included. The primary outcome was a favorable neurological outcome (Cerebral Performance Status 1 or 2) at hospital discharge. We used multilevel logistic regression to evaluate the association of sex differences, adjusting for center-level (hospital) and individual-level variables (patient background, cardiac arrest situation, and in-hospital intervention factors). For sensitivity analyses, we performed three models of multilevel logistic regression when selecting confounders.

resultsAmong the 1819 patients, 1523 (83.7%) were men, and 296 (16.3%) were women. The median age (61.0 vs. 58.0 years), presence of a witness (78.8% vs. 79.2%), and occurrence of bystander CPR (57.5% vs. 61.6%) were similar between groups. Women were more likely to present with an initial non-shockable rhythm (31.7% vs. 49.7%), as well as a non-shockable rhythm at hospital arrival (52.1% vs. 61.5%) and at ECMO initiation (48.1% vs. 57.1%). The proportion of favorable neurological outcomes was 12.3% in males and 15.9% in females (p = 0.10). Multilevel logistic regression analysis showed that the female sex was significantly associated with a favorable neurologic outcome at discharge (adjusted odds ratio: 1.60 [95% confidence interval: 1.05-2.43]; p = 0.03). This advantage in women was consistently observed in the sensitivity analyses.

conclusionsThe female sex is significantly associated with favorable neurological outcomes at hospital discharge in patients who received ECPR for OHCA.

Indexed as

Cardiopulmonary ResuscitationExtracorporeal Membrane OxygenationOut-of-Hospital Cardiac ArrestAdultAgedFemaleHumansJapanLogistic ModelsMaleMiddle AgedRegistriesRetrospective StudiesSex FactorsExtracorporeal cardiopulmonary resuscitationOut-of-hospital cardiac arrestSex differences

Identifiers

PMID39478597
PMCPMC11526675

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.