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Sex differences in survival after out-of-hospital cardiac arrest: a meta-analysis

Hao Lei1, Jiahui Hu1, Leiling Liu1

  • 1Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, 410011, Hunan, China.

Critical Care (London, England)
|October 20, 2020
PubMed

Insights

This meta-analysis found that females experiencing out-of-hospital cardiac arrest (OHCA) have lower survival rates and poorer neurological outcomes compared to males. These sex differences in OHCA prognosis warrant further investigation into underlying causes and treatment strategies.

Area of Science:

  • Cardiology
  • Public Health
  • Emergency Medicine

Background:

  • Out-of-hospital cardiac arrest (OHCA) is a significant global cause of sudden cardiac death.
  • Existing research indicates sex-based pathophysiological and clinical differences in OHCA, yet consensus on survival and prognosis disparities remains elusive.

Purpose of the Study:

  • To investigate the relationship between sex factors and prognosis in patients with OHCA.
  • To clarify existing discrepancies in the literature regarding sex differences in OHCA outcomes.

Main Methods:

  • A comprehensive meta-analysis was conducted, searching PubMed, Embase, and Cochrane databases.
  • 33 studies involving 1,268,664 patients were included, with pooled odds ratios (ORs) and 95% confidence intervals (CIs) estimated using a random-effects model.

Main Results:

  • Females with OHCA were older and more likely to experience unwitnessed arrests compared to males.
  • While survival to hospital admission showed no significant sex difference, females had significantly lower survival rates from hospital admission to discharge (OR 0.59) and poorer neurological outcomes (OR 0.62).

Conclusions:

  • Females with OHCA exhibit lower overall survival and neurological prognosis compared to males.
  • Potential contributing factors include female pathophysiological characteristics, more conservative treatment approaches, and variations in post-resuscitation care.
  • Findings should be interpreted cautiously due to potential confounding factors in the included studies.
Abstract

Keywords:
Out-of-hospital cardiac arrestPost-resuscitation carePrognosisSexSurvival

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