Sex-related Differences in Long-Term Quality of Life After Out-of-Hospital Cardiac Arrest: A Nationwide Cross-sectional Survey Study.

Background: Sex differences in survival and short-term outcomes after out-of-hospital cardiac arrest (OHCA) are well-documented, but its impact on long-term health-related quality of life (HRQoL) is unclear.

Methods: This cross-sectional survey study used the EuroQol Health Questionnaire (EQ-5D), the 12-Item Short Form Health Survey (SF-12), and the Hospital Anxiety and Depression Scale (HADS) to assess HRQoL among adult OHCA survivors in Denmark between 2001 and 2019 who were alive as of October 1, 2020. Survivors were grouped by time since cardiac arrest: 0-4 years, >4-8 years, >8-12 years, and >12 years post-arrest.

Results: Among 2,552 respondents (56.1% response rate), 2,075 were men (81.3%) and 477 were women (18.7%). The mean survey age was 60.2 years (SD 14.7) for women and 66.0 years (SD 11.8) for men. EQ-VAS and EQ-5D index scores were both lower for women than for men (69 vs. 75 and 0.76 [SD 0.21] vs. 0.84 [SD 0.17], respectively; p <0.001). The SF-12 physical and mental health scores were also lower for women (40.3 [SD 12.9] and 50.9 [SD 8.8]) compared to men (44.0 [SD 12.1] and 53.3 [SD 8.1]; p <0.001). HADS scores for anxiety (5.4 vs. 3.5; p <0.001) and for depression (4.0 vs. 3.2; p <0.001) were higher among women. In multivariable logistic regression, female sex remained significantly associated with poorer long-term HRQoL outcomes. Trends remained consistent regardless of time since cardiac arrest.

Conclusion: Female OHCA survivors reported less favorable long-term HRQoL outcomes compared to male survivors, irrespective of time elapsed since cardiac arrest.