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Sex differences in neurological outcomes for patients with In-Hospital cardiac arrest

Year: 2025

Type: article

Abstract: Sex differences in cardiac arrest outcomes had been widely studied in out-of-hospital cardiac arrest (OHCA). However, limited research has explored the impact of sex on neurological outcomes of patients with in-hospital cardiac arrest (IHCA). This study aimed to investigate the association between sex and neurological outcomes at hospital discharge in IHCA patients. A retrospective cohort study analyzed 1,536 adult IHCA patients from National Taiwan University Hospital. Neurological outcomes were categorized as favorable (CPC 1–2) or poor (CPC 3–5). Propensity score matching and logistic regression adjusted for confounders, with sensitivity and subgroup analyses validating results. The female had significantly poorer neurological outcomes compared to the male (95.34% vs. 90.80%, P < 0.001). Female sex was independently associated with poor neurological outcomes across multiple analytical approaches. In the unadjusted analysis, female patients demonstrated significantly higher odds of poor neurological outcomes (OR = 2.07, 95%CI: 1.34–3.22, P = 0.001). This association persisted after adjusting for clinical variables (Model 1: OR = 2.38, 95%CI: 1.40–4.03, P = 0.001) and propensity scores (Model 2: OR = 2.38, 95%CI: 1.39–4.01, P < 0.001). In the propensity score-matched cohort (n = 1,180), the association strengthened, with the fully adjusted model showing the robust relationship (Model 3: OR = 2.77, 95%CI: 1.54–4.99, P < 0.002). Sensitivity and subgroup analyses consistently supported these findings. Female was independently associated with poor neurological outcomes in IHCA patients. The findings highlighted the need for further research to explore underlying mechanisms and develop sex-specific strategies to improve IHCA outcomes. This study examined whether sex was associated with neurological outcomes in adults who suffered IHCA. Researchers reviewed data from over 1,500 patients at National Taiwan University Hospital to compare neurological outcomes, classified by Cerebral Performance Category (CPC) scores, between male and female patients at hospital discharge. The results showed that female patients had a significantly higher risk of poor neurological outcomes (CPC 3–5) compared to male patients after IHCA. This association persisted even after adjusting for potential confounding factors. The underlying causes for women’s poorer neurological prognosis remain unclear and warrant further investigation. This study highlighted the importance of recognizing sex differences in IHCA outcomes. Tailored, sex-specific strategies may be needed to improve neurological recovery, particularly for female patients withIHCA.

Source: BMC Cardiovascular Disorders

DOI: 10.1186/s12872-025-05150-4