Sex disparities in receipt of layperson bystander cardiopulmonary resuscitation and survival for adults who experienced out-of-hospital cardiac arrest in China

Aims

To assess sex differences in the provision of layperson bystander cardiopulmonary resuscitation (BCPR) and survival outcomes for patients with out-of-hospital cardiac arrest (OHCA) in China.

Methods

Data were collected from the Baseline Investigation of OHCA (BASIC-OHCA) registry study between August 1, 2019, and December 31, 2020. We included adult OHCAs with nontraumatic arrest and resuscitation attempts. Logistic regression models were used to analyse associations between the sex of OHCA patients and BCPR, as well as survival outcomes, with subgroup analyses by factors that significantly interacted with sex in influencing outcomes.

Results

Of 33,333 patients with OHCA, 10,650 (32.0 %) were females. Rate of layperson BCPR was significantly higher in males (19.5 %) than in females (17.3 %). After multivariable adjustment, females were less likely to receive BCPR than males (adjusted odds ratio [aOR] = 0.877, 95 % CI: 0.804–0.957). Subgroup analysis revealed that only females aged 18–44 years were significantly less likely to receive BCPR (aOR = 0.588, 95 % CI: 0.412–0.839) and females were less likely to receive BCPR with bystander-witnessed arrests (aOR = 0.789, 95 % CI: 0.701–0.887). However, no sex disparities were detected in dispatcher CPR instructions given cases (aOR = 1.175, 95 % CI: 0.887–1.556). There were no significant sex differences in survival at discharge or 30 days (aOR = 1.181, 95 % CI: 0.884–1.576) or in survival with good neurological function (aOR = 1.208, 95 % CI: 0.848–1.721).

Conclusions

In China, females with OHCA, particularly younger female individuals and with bystander-witnessed arrests, were less likely to receive BCPR than males with OHCA. No disparities were found in cases when dispatcher CPR instructions were given.