Female sex was associated with a significantly lower chance of overall survival to hospital discharge after out-of-hospital cardiac arrest compared with male sex (OR 0.73).
Meta-Analysis (n=1,268,664)
Does female sex reduce survival and favorable neurological outcomes in patients with out-of-hospital cardiac arrest compared to male sex?
Female patients with out-of-hospital cardiac arrest have significantly lower rates of survival to discharge and favorable neurological outcomes compared to males, potentially driven by differences in baseline characteristics and lower rates of in-hospital interventions.
Odds Ratio: 0.73 (95% CI 0.62–0.86)
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a leading cause of sudden cardiac death worldwide. Researchers have found significant pathophysiological differences between females and males and clinically significant sex differences related to medical services. However, conflicting results exist and there is no uniform agreement regarding sex differences in survival and prognosis after OHCA. Therefore, we investigated the relationship between the prognosis of OHCA and sex factors. METHODS: We comprehensively searched the PubMed, Embase, and Cochrane databases and obtained a total of 1042 articles, from which 33 studies were selected for inclusion. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model. RESULTS: The meta-analysis included 1,268,664 patients. Compared with males, females were older (69.7 years vs. 65.4 years, p < 0.05) and more frequently suffered OHCA without witnesses (58.39% vs 62.70%, p < 0.05). Females were less likely to receive in-hospital interventions than males. There was no significant difference between females and males in the survival from OHCA to hospital admission (OR 0.99, 95% CI 0.89-1.1). However, females had lower chances for survival from hospital admission to discharge (OR 0.59, 95% CI 0.48-0.73), overall survival to hospital discharge (OR 0.73, 95% CI 0.62-0.86), and favorable neurological outcomes (OR 0.62, 95% CI 0.47-0.83) compared with males. CONCLUSIONS: Our results indicate that the overall discharge survival rate of females is lower than that of males, and females face a poor prognosis of the nervous system. This is likely related to the pathophysiological characteristics of females, more conservative treatment measures compared with males, and different post-resuscitation care. However, these findings should be interpreted with caution due to the presence of several confounding factors.
Lei et al. (Mon,) conducted a meta-analysis in Out-of-hospital cardiac arrest (OHCA) (n=1,268,664). Female sex vs. Male sex was evaluated on Survival from OHCA to discharge (OR 0.73, 95% CI 0.62-0.86). Female sex was associated with a significantly lower chance of overall survival to hospital discharge after out-of-hospital cardiac arrest compared with male sex (OR 0.73).