This prospective multicentre Chinese cohort included 33,650 EMS-treated out-of-hospital cardiac arrests in 2020; 32.1% were female. Despite less favorable resuscitation characteristics and prehospital care, females had higher adjusted odds of prehospital return of spontaneous circulation (OR 1.21, 95% CI 1.06–1.38) and survival to hospital admission (OR 1.33, 95% CI 1.15–1.55). There was no statistically significant sex difference in survival to hospital discharge or 30 days (adjusted OR 0.85, 95% CI 0.66–1.10) or favorable neurological outcome (adjusted OR 0.84, 95% CI 0.62–1.14).
Female patients had better adjusted early resuscitation outcomes, but no clear survival or neurological advantage at later assessment. These observational findings support examining disparities across the full resuscitation pathway rather than inferring equivalent longer-term outcomes.
Study limitation: Observational adjustment cannot exclude residual confounding; the abstract does not report absolute survival or neurological outcome rates.
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