title: Gender and survival after sudden cardiac arrest: A systematic review and meta-analysis.
abstract: BACKGROUND
  Conflicting results exist regarding the impact of gender on early survival after sudden cardiac arrest (SCA). We aimed to assess the association between female gender and early SCA survival.
  
  
  METHODS
  We searched Embase, MEDLINE, EBM Reviews, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (between 1948 and January 2014) for studies evaluating the association between gender and survival after SCA. Two independent reviewers selected studies of any design or language. Pooled odds-ratios (OR) and 95% confidence intervals (CIs) were estimated using a random-effects model. Additional sensitivity analyses and meta-regression were carried out to explore heterogeneity.
  
  
  RESULTS
  Thirteen studies were included involving 409,323 patients. Women were more likely to present with SCA at home, less likely to have witnessed SCA, had a lower frequency of initial shockable rhythm but were more likely to receive bystander CPR. After adjustment for these differences, women were more likely to survive at hospital discharge (OR 1.1, 95% CI 1.03-1.20, p=0.006, I(2)=61%). This association persisted in multiple sensitivity analyses.
  
  
  CONCLUSIONS
  This meta-analysis of observational studies demonstrates that women have increased odds of survival after SCA. Further studies are needed to address mechanisms explaining this discrepancy.
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Intensive Care Unit, Cochin Hospital, Paris, France; Paris Sudden Death Expertise Center, Paris, France. Electronic address: wulfran.bougouin@gmail.com.
authors.forename: Wulfran
authors.initials: W
authors.lastname: Bougouin
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Paris Sudden Death Expertise Center, Paris, France.
authors.forename: Hazrije
authors.initials: H
authors.lastname: Mustafic
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Paris Sudden Death Expertise Center, Paris, France; Cardiology Department, European Georges Pompidou Hospital, Paris, France.
authors.forename: Eloi
authors.initials: E
authors.lastname: Marijon
authors.affiliation: Division of Preventive Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Paris Sudden Death Expertise Center, Paris, France; Emergency Department, Cochin Hospital, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Dumas
authors.affiliation: Paris Cardiovascular Research Center - INSERM U970 (PARCC), France.
authors.forename: Anna
authors.initials: A
authors.lastname: Barbouttis
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Paris Sudden Death Expertise Center, Paris, France; SAMU de Paris, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Jabre
authors.affiliation: Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Paris Sudden Death Expertise Center, Paris, France.
authors.forename: Frankie
authors.initials: F
authors.lastname: Beganton
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Paris Sudden Death Expertise Center, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Empana
authors.affiliation: Sydney Medical School, Australia.
authors.forename: David S
authors.initials: DS
authors.lastname: Celermajer
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Intensive Care Unit, Cochin Hospital, Paris, France; Paris Sudden Death Expertise Center, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Cariou
authors.affiliation: Paris Descartes University, France; Paris Cardiovascular Research Center - INSERM U970 (PARCC), France; Paris Sudden Death Expertise Center, Paris, France; Cardiology Department, European Georges Pompidou Hospital, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Jouven
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends
keywords: Gender; Out-of-hospital cardiac arrest; Prognosis; Sex; Sudden death; Ventricular fibrillation