Sex differences in epidemiology, care, and outcomes in patients with out-of-hospital cardiac arrest in China
In brief
Chinese women with cardiac arrest had 33% higher odds of surviving to hospital admission
In a 33,650-patient Chinese cohort, women were less likely to receive favorable resuscitation and prehospital care, yet had higher adjusted odds of return of circulation before hospital arrival and survival to admission. That early advantage did not persist: survival to discharge or 30 days and favorable neurological outcomes did not differ significantly by sex, underscoring the need to assess the full course of care.
- Journal
- Resuscitation (Q1)
- Published
- 25 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Jingjing Ma, Hongying Liang, Nan Wang, Weiqi Yue, Leilei Yang, Ruixue Song, et al.
- PMID
- 42790854
- DOI
- 10.1016/j.resuscitation.2026.111331
Why clinicians should know about it
- Picked for Emergency Medicine (paper of the day, 28 September 2026): Sex differences in OHCA incidence, care, and outcomes in China
Abstract
BACKGROUND: Data on sex differences in out-of-hospital cardiac arrest (OHCA) are well described in developed countries, but scarce in developing countries. METHODS: This prospective, multicenter, population-based observational cohort study used data from the Baseline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA) study collected between January 1, 2020, and December 31, 2020. Differences in outcomes were assessed using multivariable hierarchical logistic regression, with prespecified subgroup analyses and interaction tests. RESULTS: The age-standardized incidence rate of emergency medical system (EMS)-treated OHCA was higher in males than in females (48.1 vs 20.8 per 100,000 person-years, IRR = 2.31, 95% CI: 2.26-2.36) in China. Among 33,650 EMS-treated OHCA patients, 10,793 (32.1%) were females. Females had less favorable resuscitation characteristics and prehospital care than males. In multivariable models, females had significantly higher odds of prehospital return of spontaneous circulation (adjusted odds ratio [OR] = 1.21, 95% CI: 1.06-1.38) and survival to hospital admission (adjusted OR = 1.33, 95% CI: 1.15-1.55). However, no significant sex difference was observed for survival to hospital discharge or 30 days (adjusted OR = 0.85, 95% CI: 0.66-1.10), or favorable neurological outcome (adjusted OR = 0.84, 95% CI: 0.62-1.14). In subgroup analyses, females had lower odds of survival and favorable neurological outcome than males among patients aged ≥50 years, those with shockable rhythm, and those without prehospital epinephrine administration. CONCLUSIONS: In China, females demonstrated better prehospital resuscitation outcomes. However, this early advantage was lost by discharge. These findings highlight the need for integrated evaluation across prehospital and in-hospital care to inform disparity-reduction strategies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.