Delays in bystander cardiopulmonary resuscitation (CPR) are associated with worse out-of-hospital cardiac arrest (OHCA) outcomes. Whether disparities exist in time to CPR between women and men is unknown. We included witnessed OHCAs treated with bystander CPR from the Cardiac Arrest Registry Enhancing Survival between 2013–2021. The primary outcome was time to first bystander CPR, and secondary outcomes were survival to hospital discharge and favorable neurological survival. Hierarchical ordinal regression was used to model time to first CPR, which estimates the odds of having a 2-minute longer delay (from 0 to ≥10 minutes) in receiving bystander CPR. The model included sex, age, race, location of arrest, cardiac arrest etiology, day of week, and season as fixed effects and EMS agency as a random effect to account for clustering of patients within an agency. Of 78,043 patients with a witnessed OHCA that received bystander CPR, 25,197 (32.3%) were women. The median [IQR] time to first bystander CPR was 2 [1,5] minutes for both women and men. In adjusted analysis, time to bystander CPR was similar in men and women ( = 0.26). Moreover, there was a statistically significantly graded inverse association between time to bystander CPR and survival. For patients with witnessed OHCA that received bystander CPR, women and men had similar times to CPR, although 5-minute or greater delays in initiating CPR was not uncommon. Delays in bystander CPR in OHCA were associated with worse survival outcomes.

中文翻译：

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院外心脏骤停按患者性别划分的旁观心肺复苏时间

旁观者心肺复苏 (CPR) 的延迟与较差的院外心脏骤停 (OHCA) 结局相关。男女之间进行心肺复苏的时间是否存在差异尚不清楚。我们纳入了 2013 年至 2021 年间接受心脏骤停登记处的旁观者心肺复苏 (CPR) 治疗的目击 OHCA。主要结局是首次旁观者进行心肺复苏的时间，次要结局是出院存活率和良好的神经系统存活率。使用分层序数回归对首次 CPR 时间进行建模，估计接受旁观者 CPR 延迟 2 分钟（从 0 到 ≥10 分钟）的可能性。该模型将性别、年龄、种族、逮捕地点、心脏骤停病因、星期几和季节作为固定效应，将 EMS 机构作为随机效应，以解释机构内患者的聚集情况。在 78,043 名目击 OHCA 接受旁观者心肺复苏的患者中，25,197 名 (32.3%) 是女性。对于女性和男性，首次旁观者进行心肺复苏所需的中位 [IQR] 时间均为 2 [1,5] 分钟。在调整分析中，男性和女性进行旁观者心肺复苏的时间相似 (= 0.26)。此外，旁观者心肺复苏时间与生存率之间存在统计学上显着的负相关关系。对于目击 OHCA 接受旁观者心肺复苏的患者，女性和男性的心肺复苏时间相似，尽管延迟 5 分钟或更长时间开始心肺复苏的情况并不少见。OHCA 中旁观者心肺复苏的延迟与较差的生存结果相关。