Gender disparities in out-of-hospital cardiac arrest: implications for public health and bystander interventions in Zhengzhou.

Background: Out-of-hospital cardiac arrest (OHCA) remains a critical public health crisis in China, with survival rates below 1%, notably lower than those reported in developed nations (10%-12%). Gender disparities have emerged as crucial determinants of OHCA outcomes; however, China-specific evidence remains limited. Methods: We conducted a retrospective cohort study of 3,272 adult non-traumatic OHCA patients treated at the Zhengzhou Emergency Medical Rescue Center between 2017 and 2020. Patient characteristics and interventions were analyzed using multivariable logistic regression to assess their associations with prehospital return of spontaneous circulation (ROSC). Results: Among 3,272 OHCA patients, women accounted for 27.6% ( Conclusion: Significant gender disparities were identified in prehospital outcomes of OHCA patients in Zhengzhou. Compared with men, women were older and less likely to experience a cardiac arrest in public locations, have the event witnessed, receive cardiopulmonary resuscitation (CPR) from a bystander, present with a shockable rhythm, or require an automated external defibrillator (AED). These factors collectively contributed to substantially lowered prehospital ROSC rates among women. Targeted public health strategies-such as expanding inclusive CPR training, promoting gender-sensitive AED use, enhancing community awareness of female resuscitation, and optimizing emergency medical service protocols-are urgently required to reduce these disparities.