Key result
Female sex is linked to ~13% lower odds of receiving public bystander CPR.
Why the study?
Women are less likely to receive bystander CPR in public, motivating an assessment of whether sex was associated with bystander CPR and survival to hospital discharge after public out-of-hospital cardiac arrest in North Carolina and Singapore.
Is female sex associated with lower rates of bystander cardiopulmonary resuscitation and survival to hospital discharge compared to male sex in adults experiencing public out-of-hospital cardiac arrest in North Carolina and Singapore?
Cohort (n=10,445)
Yes
Is female sex associated with lower rates of bystander cardiopulmonary resuscitation and survival to hospital discharge compared to male sex in adults experiencing public out-of-hospital cardiac arrest in North Carolina and Singapore?
Across two distinct geographic regions, women experiencing public out-of-hospital cardiac arrest were significantly less likely to receive bystander CPR than men, though subsequent survival disparities differed between the United States and Singapore.
Answers are grounded in this paper and cite their sources.
Females received less public bystander CPR; confirms sex disparity but leaves open survival impact and targeted interventions.
Aim Women are less likely to receive bystander cardiopulmonary resuscitation (CPR) in public. The study aims to assess if sex in patients with public out-of-hospital cardiac arrests (OHCAs), was associated with bystander CPR and survival to hospital discharge, in North Carolina and Singapore. Methods We conducted a retrospective cohort study of adult (≥18 years) OHCAs of the Cardiac Arrest Registry to Enhance Survival (North Carolina, 2013 – 2022) and the Pan-Asian Resuscitation Outcomes Study (Singapore, 2010 – 2020). Using multivariable logistic regression, we examined the association of sex with bystander CPR and survival to hospital discharge adjusting for potential confounding variables (e.g. age, year of arrest). Results We analyzed data from 6,828 OHCAs in North Carolina and 3,617 OHCAs in Singapore. Public bystander CPR rates were 48% for males and 44% for females in North Carolina [adjusted odd ratio (aOR) 0.87; 95% confidence interval (CI) 0.77, 0.99], and 59% for males and 52% for females in Singapore [aOR 0.78; 95% CI (0.62, 0.98)]. The proportion surviving to hospital discharge in North Carolina were 24% for males and 26% for females [aOR 1.15; 95% CI (1.00, 1.33)], and 12% for males and 9% for females in Singapore [aOR 0.63; 95% CI (0.43, 0.93)]. Conclusion Females were less likely to receive bystander CPR than males in public in both North Carolina and Singapore, irrespective of age. However, females were less likely to survive to hospital discharge compared to males in Singapore, whereas the opposite was seen in North Carolina.
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Wee et al. (2026) conducted a cohort in Public out-of-hospital cardiac arrest (n=10,445). Female sex vs. Male sex was evaluated on Bystander cardiopulmonary resuscitation (CPR) and survival to hospital discharge (aOR 0.87, 95% CI 0.77-0.99). Female sex was associated with lower public bystander CPR rates than males in North Carolina (44% vs 48%; aOR 0.87, 95% CI 0.77-0.99) and Singapore (52% vs 59%; aOR 0.78, 95% CI 0.62-0.98).
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