Underlying reasons for sex difference in survival following out-of-hospital cardiac arrest: a mediation analysis

• DOI: 10.1093/europace/euae126
• Publication Date: 2024-05-14T17:46:59Z
• Authors: Charlotte Miedel; Martin Jonsson; Mariana Dragas; Therese Djärv; Per Nordberg; Araz Rawshani; Andreas Claesson; Sune Forsberg; Anette Nord; Johan Herlitz; Gabriel Riva
• Keywords: Male; Emergency Medical Services; Electric Countershock; Women’s health; 03 medical and health sciences; Sex Factors; 0302 clinical medicine; Kardiologi och kardiovaskulära sjukdomar; Clinical Research; Risk Factors; Humans; Registries; Aged; Sweden; Aged, 80 and over; Mediation Analysis; Gender; Middle Aged; Cardiopulmonary Resuscitation; SCD; Survival Rate; Socioeconomic Factors; OHCA; Ventricular arrhythmia; Sex; Female; Cardiology and Cardiovascular Disease; Out-of-Hospital Cardiac Arrest

Abstract Aims Previous studies have indicated a poorer survival among women following out-of-hospital cardiac arrest (OHCA), but the mechanisms explaining this difference remain largely uncertain. This study aimed to assess after OHCA and men explore role of potential mediators, such as resuscitation characteristics, prior comorbidity, socioeconomic factors. Methods results was population-based cohort including emergency medical service-treated reported Swedish Registry for Cardiopulmonary Resuscitation in 2010–2020, linked nationwide healthcare registries. The relative risks (RR) 30-day were compared men, mediation analysis performed investigate importance mediators. Total 43 226 OHCAs included, which 14 249 (33.0%) women. Women older had lower proportion shockable initial rhythm. crude 6.2% 10.7% [RR 0.58, 95% confidence interval (CI) = 0.54–0.62]. Stepwise adjustment rhythm attenuated association RR 0.85 (95% CI 0.79–0.91). Further adjustments age factors null (RR 0.98; 0.92–1.05). Mediation showed that explained ∼50% negative female sex on survival. Older disposable income second third most important variables, respectively. Conclusion men. poor prognosis is by rhythm, at presentation, income.