REUTERS: Women suffering from cardiac arrest outside a hospital are less likely to receive help from bystanders and have less chance of survival than men, a recent Dutch study showed.
The results are in line with what a separate study found in the United States last year: men were more likely to receive support from viewers and more chances of survival than women.
For the new study, conducted in a province of the Netherlands, Dr. Hanno Tan at the University of Amsterdam and colleagues examined data on over 5,700 people who had cardiac arrests in the community. All were treated by local emergency medical services (EMS) – but before EMS arrived on the scene, only about 68% of women had received resuscitation attempts by bystanders, compared to about 73% of men.
"This indicates a commonality here that is happening in more countries: it would be very interesting to see if it is the same all over the world," said Dr. Lorrel Brown Toft of the University of Louisville School of Medicine in Kentucky, who was not involved in the study, he told Reuters by phone.
Han's team found that despite EMS resuscitation attempts, only 12.5% of women survived and were discharged from the hospital, compared to about 20% of men.
Cardiac arrest involves the sudden loss of cardiac function, respiration and consciousness. Chest compressions or CPR given by the bystanders cannot restore a normal heart rhythm, but can gain time until rescuers arrive, keeping blood flow to vital organs.
Bystanders play a crucial role, as the survival of a person in cardiac arrest depends on the speed with which witnesses provide CPR and notify the emergency services of the event.
In the new study, however, even when emergency care was readily provided, women had only half the chance of men having a "shocking rhythm", which is a heart rhythm that can be reset with a defibrillator , to start the heart again, the researchers wrote in the European Heart Journal.
This difference, the authors say, could indicate the underlying biological factors that cause the shocking rhythm to dissolve into a flat line more quickly in women than in men.
They found, for example, that women with cardiac arrest were more likely to suffer from conditions associated with a lower rate of shock, such as type 2 diabetes or stroke.
On the other hand, the differences observed in the study could also be due to a longer delay before passers-by recognize that a woman is in cardiac arrest.
People might not realize that women can suffer from cardiac arrests just like men, Tan told Reuters Health by telephone.
"For many of us, cardiac arrest occurs mainly, not in the hospital, but in public spaces. Passersby must know that women can suffer cardiac arrests as much as men can," Tan said.
The victims themselves may not be able to recognize the warning signs of a cardiac event. For example, symptoms of heart attack, a common trigger of cardiac arrest, can be overlooked by women, for whom symptoms can manifest themselves as fatigue, nausea or pain in the neck or jaw, while men tend to report more prominent symptoms like chest pain.
Toft, an intensive care cardiologist who directs CPR training programs, pointed out that while you can't change the way a cardiac arrest occurs, make sure that women get spectator support whenever men contribute to improve survival.
There are many reasons why women may receive less support from bystanders than men. Women tend to survive men and are more likely to be widowed or live alone, increasing their chances of having cardiac events when no one is around. Bystanders may also have inhibitions on performing chest compressions on a woman.
Toft notes that even during simulated CPR training sessions, female victims are less likely to receive help than men.
"We must realize that there are some specific barriers for women and if we can overcome these barriers and improve our education, we could help women more with standard CPR," he added.
. (tagsToTranslate) Netherlands (t) CPR (t) medical health (t) EMS (t) cardiac arrest (t) Toft