Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age

The aim of this study was to determine relative risk (RR) of incidence and fatality of out-of-hospital cardiac arrest (OHCA) by gender and oestrogen status. In a prospective, population-based observational study from 1998 through 2007, incidence and neurologically intact 1-month survival after OHCA were compared by gender after grouping: 0–12 years, 13–49 years, and ≥50 years according to menarche and menopause age. Among 26 940 cardiac arrests, there were 11 179 females and 15 701 males. Age-adjusted RR of females for OHCA incidence compared with males was 0.72 [95% confidence interval (CI), 0.58–0.91] in age 0–12 years, 0.39 (95% CI, 0.37–0.43) in age 13–49 years, and 0.54 (95% CI, 0.52–0.55) in age ≥50 years. Females aged 13–49 years had a significantly higher good neurological outcome than males [adjusted odds ratio (OR), 2.00 (95% CI 1.21–3.32)]. This sex difference was larger than that in the other age groups [adjusted OR, 0.82 (95% CI, 0.06–12.02) in age 0–12 years and 1.23 (95% CI, 0.98–1.54) in age ≥50 years]. Reproductive females had a lower incidence and a better outcome of OHCA than females of other ages and males, which might be explained by cardioprotective effects of endogenous oestrogen on OHCA.