Sex differences in the quality-of-life and functional outcome of cardiac arrest survivors

Aim: Although survival from out-of-hospital cardiac arrest (OHCA) is improving, little is known about the long-term outcome of survivors. In this study, we assess the impact of sex on 12 month functional recovery and health-related quality-of-life (HROoL) outcomes in OHCA survivors. Methods: Between 2010 and 2016, consecutive adult OHCA survivors were invited to participate in structured telephone interviews using the Glasgow Outcome Scale-Extended (GOSE), the EuroQol-5D (EQ-5D), and 12-Item Short Form (SF-12) health survey. Results: Of the 2300 patients discharged alive, 175 (7.6%) died during the follow-up period with the rate of death at 12 months being higher in women compared to men (10.4% vs. 6.4%; p = 0.002). Of the 2125 12 month survivors, 1752 (82.5%) participated in the interviews. Unadjusted outcomes were consistently poorer for females compared to males, with fewer women reporting good functional recovery (GOSE >= 7, 53.5% vs. 64.8%, p < 0.001) and living at home without care (60.7% vs. 76.4%, p < 0.001). After adjustment, female sex reduced the odds of good functional recovery (adjusted odds ratio [AOR] 0.69, 95% CI: 0.53-0.88; p = 0.004), living at home without care (AOR 0.57, 95% CI: 0.43-0.76; p < 0.001), an EQ-5D index score of 1 (AOR 0.57, 95% CI: 0.43-0.75; p < 0.001), an SF-12 mental component summary >= 50 (AOR 0.56, 95% CI: 0.40-0.78; p = 0.001) and an SF-12 physical component summary >= 50 (AOR 0.53, 95% CI: 0.39-0.71; p < 0.001). Conclusions: Women report poorer functional recovery and HROoL after OHCA. Further research is needed to better understand the reasons for these disparities.