Sex-related differences in long-term quality of life after out-of-hospital cardiac arrest: a nationwide cross-sectional survey study

AIMS: Sex differences in survival and short-term outcomes after out-of-hospital cardiac arrest (OHCA) are well documented, but its impact on long-term health-related quality of life (HRQoL) is unclear. METHODS AND RESULTS: This cross-sectional survey study used the EuroQol Health Questionnaire (EQ-5D), the 12-Item Short-Form Health Survey (SF-12), and the Hospital Anxiety and Depression Scale (HADS) to assess HRQoL among adult OHCA survivors in Denmark between 2001 and 2019 who were alive as of 1 October 2020. Survivors were grouped by time since cardiac arrest: 0-4, >4-8, >8-12, and >12 years post-arrest. Among 2552 respondents (56.1% response rate), 2075 were men (81.3%) and 477 were women (18.7%). The mean survey age was 60.2 years (SD 14.7) for women and 66.0 years (SD 11.8) for men. EuroQol Visual Analogue Scale and EuroQol Health Questionnaire index scores were both lower for women than for men [69 vs. 75 and 0.76 (SD 0.21) vs. 0.84 (SD 0.17), respectively; P < 0.001]. The SF-12 physical and mental health scores were also lower for women [40.3 (SD 12.9) and 50.9 (SD 8.8)] compared with men [44.0 (SD 12.1) and 53.3 (SD 8.1); P < 0.001]. Hospital Anxiety and Depression Scale scores for anxiety (5.4 vs. 3.5; P < 0.001) and for depression (4.0 vs. 3.2; P < 0.001) were higher among women. In multivariable logistic regression, female sex remained significantly associated with poorer long-term HRQoL outcomes. Trends remained consistent regardless of time since cardiac arrest. CONCLUSION: Female OHCA survivors reported less favourable long-term HRQoL outcomes compared with male survivors, irrespective of time elapsed since cardiac arrest.