ArticleCritical care (London, England)2025
Sex disparities in ICU care and outcomes after cardiac arrest: a Swiss nationwide analysis.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Sex-related differences in end-of-life decision-making in patients with traumatic brain injury: a systematic review and meta-analysis.BMC palliative care · 2026Pooled it
- Sex and gender considerations in randomized controlled trials in critical care nephrology: a meta-epidemiologic study.BMC medicine · 2025Pooled it
- Timing matters: sex differences in treatment limitation decisions in intensive care.Critical care (London, England) · 2026Article
- Urgent Admission and Inequities in Acute Hospital Stay in Canada.International journal of environmental research and public health · 2026Article
- Effects of direct tracheostomy on ventilator weaning in patients intubated for Guillain-Barré syndrome.Annals of intensive care · 2026Article
- Article
- Sex differences in advance directives and their clinical translation among critically ill adults: results from the ADVISE study.Annals of intensive care · 2025Article
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Authors and funding
15 authors.
Funding
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Abstract
backgroundConflicting data exist regarding sex-specific outcomes after cardiac arrest. This study investigates sex disparities in the provision of critical care and outcomes of in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA) patients.
methodsAnalysis of adult cardiac arrest patients admitted to certified Swiss intensive care units (ICUs) (01/2008-12/2022) using the nationwide prospective ICU registry. The primary outcome was ICU mortality, with secondary outcomes including ICU admission probability and advanced treatment provision.
resultsAmong 41,733 individuals (34.9% women), 21,692 patients (30.6% women) were admitted to ICUs (16,571 OHCA patients/5121 IHCA patients). Women were less likely to be admitted to the ICU than men (incidence rate ratio 0.82 [95% CI 0.80-0.85] and had a higher ICU mortality (41.8% vs 36.2%; p < 0.001). Mortality differences were more pronounced in OHCA patients (unadjusted HR: 1.35 [95% CI 1.28-1.43]; adjusted HR: 1.19 [95% CI 1.12-1.25]). In IHCA patients, mortality differences were less pronounced (unadjusted HR: 1.14 [95% CI 1.04-1.25]) and vanished after adjustment for confounders: adjusted HR: 1.03 [95% CI 0.94-1.13]). Women after cardiac arrest were older, more severely ill, and received fewer interventions before (44.7% vs 54.0%; p < 0.001) and during ICU stay. A subgroup analysis of 11,202 patients revealed that treatment limitations were more frequent in women (46.7% vs 38.7%; p < 0.001). However, these limitations were associated with an increased risk of death in both sexes.
conclusionsThis study highlights sex disparities in short-term mortality and ICU resource allocation among cardiac arrest patients, with women potentially facing disadvantages, in particular after OHCA. The limitations of ICU registry data, particularly the lack of detailed cardiac arrest-specific and comorbidity information, restrict definitive conclusions. Future research should prioritize prospective studies with more granular data to better understand and address these disparities.
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