Sex-based differences in clinical outcomes for non-prescription drug-associated out-of-hospital cardiac arrest.
Resuscitation Plus · 2026-10-08 · Observational study
Abstract
INTRODUCTION: Non-prescription drug toxicity contributes to a substantial proportion of out-of-hospital cardiac arrests (OHCAs). Among OHCAs overall, previous reports have shown lower survival among females, compared to males. We examined sex-based differences in outcomes among non-prescription drug-associated OHCA (DA-OHCA). METHODS: In this population-based observational cohort study using data from the BC Cardiac Arrest Registry (2019-24), we included emergency medical services (EMS)-treated OHCAs that had evidence of recent non-prescription drug use. The primary outcome was favorable neurological outcome, and secondary outcomes included survival at hospital discharge, prehospital return of spontaneous circulation (ROSC), and ROSC at emergency department (ED) arrival. We assessed the association between female sex (vs male) and outcomes using multivariable logistic regression models, adjusted for Utstein variables. RESULTS: Among 47,051 EMS-Assessed OHCA, there were 4926 adult EMS-assessed DA-OHCA. We included 3133 adult EMS-treated DA-OHCAs, of whom 864 (28%) were female and 2269 (72%) were male, with a median age of 38 (interquartile range [IQR] 30-49) and 40 (IQR 32-52) years, respectively. Favorable neurological outcomes occurred in 108 (13%) females and 212 (9.6%) males. Female sex was not associated with favorable neurological outcome (adjusted odds ratio [aOR] 1.32, 95% CI 0.97, 1.79), prehospital ROSC (aOR 1.00, 95% CI 0.83, 1.19), or ROSC at ED arrival (aOR 1.01, 95% CI 0.84, 1.22), but was associated with an increased odds survival to hospital discharge (aOR 1.34; 95% CI 1.01, 1.77). CONCLUSIONS: Among DA-OHCA, female sex was not independently associated with favorable neurological outcomes, but was associated with a higher odds of survival to hospital discharge.
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Tags
Mortality & survival · Quality of life & function · Sex & gender
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