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Female sex and prognosis following out-of-hospital cardiac arrest: Does lack of statistical significance equal clinically insignificant?

      Sex as a predictor of survival for non-traumatic out-of-hospital cardiac arrest (OHCA) has been an area of interest with conflicting results. Previous studies examining sex-based differences in outcomes showed that women who suffer OHCA have lower likelihood of survival to hospital discharge then their male counterparts.
      • Morrison L.J.
      • Schmicker R.H.
      • Weisfeldt M.L.
      • et al.
      Effect of gender on outcome of out of hospital cardiac arrest in the Resuscitation Outcomes Consortium.
      • Mody P.
      • Pandey A.
      • Slutsky A.S.
      • et al.
      Gender-based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest.
      • Bosson N.
      • Kaji A.H.
      • Fang A.
      • et al.
      Sex differences in survival from out-of-hospital cardiac arrest in the era of regionalized systems and advanced post-resuscitation care.
      Contrary to this evidence, women have a higher likelihood of return of spontaneous circulation compared to men.
      • Blom M.T.
      • Oving I.
      • Berdowski J.
      • van Valkengoed I.G.M.
      • Bardai A.
      • Tan H.L.
      Women have lower chances than men to be resuscitated and survive out-of-hospital cardiac arrest.
      Poor outcomes are likely driven by sex disparities in post-resuscitation care; women who suffer OHCA are less likely to receive bystander cardiopulmonary resuscitation (CPR), less frequently experience witnessed cardiac arrest in a public location and have non-shockable initial rhythms.
      • Blewer A.L.
      • McGovern S.K.
      • Schmicker R.H.
      • et al.
      Gender disparities among adult recipients of bystander cardiopulmonary resuscitation in the public.
      • Karlsson V.
      • Dankiewicz J.
      • Nielsen N.
      • et al.
      Association of gender to outcome after out-of-hospital cardiac arrest–a report from the International Cardiac Arrest Registry.
      However, when adjusted for these Utstein variables, sex alone may not a significant predictor of survival after non-traumatic OHCA.
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