There has been more than one instance recently of observed associations between female gender and improved outcomes. Female physicians have lower rates of 30-day mortality and readmission rates for hospitalized elderly, and have better outcomes among female patients with acute myocardial infarction.
Now, another set of data showing improved survival after in-hospital cardiac arrest.
This is a retrospective review of 1,082 in-hospital cardiac arrests between 2005 and 2017 in which the gender of the code team leader could be ascertained. The minority – 30.2% – were led by a female physician. Location within the hospital, shockable rhythm, time of day, and patient age were similar between the male and female physician-led cardiac arrest cohorts. With male physicians, ROSC was 71.7% and survival to discharge was 29.8%, bested by female physicians with 76.8% ROSC and 37.3% survival. In a sample size this small, there are many potentially unmeasured confounders regarding the underlying health and type of arrest that may have contributed to the baseline likelihood of ROSC and survival – but this is still quite the interesting association.
Unfortunately, this brief analysis cannot tweeze out specifically why the female physician-led cohort had better outcomes. Their data set recorded compression depth and rate, and these were effectively the same – but they do not have medication use, timing, and other relevant attributes for evaluation. They make some further associations between physician and nurse gender, but the confidence intervals simply explode regarding whether any observed survival advantage may have occurred by chance alone. I expect other inpatient cardiac arrest registries or databases may have more granular data to either confirm or refute this association – and, hopefully, if such an association continues to be observed, to better determine the practice patterns associated with any increased survival.
Lastly, it is reasonable to be concerned regarding publication bias relating to these such reports of gender-based outcomes. It is probably editorially more interesting – and certainly seems more likely to get picked up by the lay press – to report associations favoring the female gender than the other way around. Perhaps a bit more research seems warranted before condemning men to the scrap heap of history. I hope, for my own sake!
“Female Physician Leadership During Cardiopulmonary Resuscitation Is Associated With Improved Patient Outcomes”
https://journals.lww.com/ccmjournal/Abstract/onlinefirst/Female_Physician_Leadership_During_Cardiopulmonary.96124.aspx
I can’t fathom why such useless studies are done.
Useless topic.
Useless because it is retrospective and small and anyway won’t tell anything about causation.
We already had women agianst men or yound against old docs in the wards, on mega retrospective studies that were as useless and untoward use of public money .
Who will fund an RCt to set the case ?
How will you blind an RCT to determine whether males or females rule ?
What will the consequences be ? Choose your arrest leader ? Fire the losing side, whatever the effect size ?
What next ?
Blond haired dark eyed males vs dark haired blue eyed females in radiologic diagnosis accuracy ?
This curriculum vitae industry is , I think, a shame and a waste of time an wages, let alone funding.
Ioannidis is right, we see too much junk publications.