Does Provider Gender Matter? Guideline Concordance In Post-Cardiac Arrest Care

Introduction: Recent studies have suggested that female physicians are more likely to adhere to clinical practice guidelines in medical care. When clinical guidelines for post-cardiac arrest care are adhered to patients have better outcomes. Hypothesis: We hypothesize that gender of the attending provider may affect guideline concordance in post-cardiac arrest care. Methods: We identified 139 out-of-hospital cardiac arrest patients treated at an academic tertiary care facility between 12/2013 and12/2016. Patients were over 18 years of age, suffered a medical cardiac arrest and were comatose at hospital admission. Demographic data and arrest characteristics were collected. The gender of the admitting provider and the provider who lead the first documented family meeting were abstracted. To assess for evidence based practice, we utilized 4 previously cited guidelines that are associated with improved survival; a.) was coronary angiography completed within 24 hours of admission, b.) was targeted temperature management initiated, c.) was target temperature achieved, and d.) did withdrawal of life sustaining therapy occur before 72 hours from return of spontaneous circulation? Results: Of the total cohort, 61.9% were male, mean age was 57.5 ±16.2 years, 36.6% had an initial shockable rhythm and 41.7% received bystander CPR. Fifty-six (40.3%) individuals survived to hospital discharge. Approximately 28.8% of the cohort was admitted to the hospital by a female attending physician. Guideline adherence by provider gender is described in the Table. No statistically significant differences were appreciated when examining the frequency of guideline concordant care and attending physician gender. Conclusions: In this small cohort of post-cardiac arrest patients, provider gender does not appear to affect post-arrest care guideline adherence. Further study in a large, multi-center cohort may yield different findings.