Sex-based differences in clinical outcomes for non-prescription drug-associated out-of-hospital cardiac arrest
- 1British Columbia Resuscitation Research Collaborative, British Columbia, Canada
- 2Faculty of Medicine, University of British Columbia, British Columbia, Canada
Abstract
Introduction
Non-prescription drug toxicity contributes to a substantial proportion of out-of-hospital cardiac arrests (OHCAs). Among OHCAs overall, previous reports have shown lower survival among females, compared to males. We examined sex-based differences in outcomes among non-prescription drug-associated OHCA (DA-OHCA).Methods
In this population-based observational cohort study using data from the BC Cardiac Arrest Registry (2019-24), we included emergency medical services (EMS)-treated OHCAs that had evidence of recent non-prescription drug use. The primary outcome was favorable neurological outcome, and secondary outcomes included survival at hospital discharge, prehospital return of spontaneous circulation (ROSC), and ROSC at emergency department (ED) arrival. We assessed the association between female sex (vs male) and outcomes using multivariable logistic regression models, adjusted for Utstein variables.Results
Among 47,051 EMS-Assessed OHCA, there were 4926 adult EMS-assessed DA-OHCA. We included 3133 adult EMS-treated DA-OHCAs, of whom 864 (28%) were female and 2269 (72%) were male, with a median age of 38 (interquartile range [IQR] 30-49) and 40 (IQR 32-52) years, respectively. Favorable neurological outcomes occurred in 108 (13%) females and 212 (9.6%) males. Female sex was not associated with favorable neurological outcome (adjusted odds ratio [aOR] 1.32, 95% CI 0.97, 1.79), prehospital ROSC (aOR 1.00, 95% CI 0.83, 1.19), or ROSC at ED arrival (aOR 1.01, 95% CI 0.84, 1.22), but was associated with an increased odds survival to hospital discharge (aOR 1.34; 95% CI 1.01, 1.77).Conclusions
Among DA-OHCA, female sex was not independently associated with favorable neurological outcomes, but was associated with a higher odds of survival to hospital discharge.
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BibTeX
@article{prasongsukarn2026sexbased,
title = {{Sex-based differences in clinical outcomes for non-prescription drug-associated out-of-hospital cardiac arrest}},
author = {Aticha Amie Prasongsukarn and Valerie Mok and Jane Hsu and Vivian Le and Lovepreet Singh and Jacob Hutton and Frank Scheuermeyer and Morgan Haines and Chris Cartwright and Rohan Hundal and Jim Christenson and Brian Grunau},
journal = {Resuscitation plus},
year = {2026},
month = oct,
doi = {10.1016/j.resplu.2026.101526},
url = {https://europepmc.org/article/PMC/PMC13717888},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Sex-based differences in clinical outcomes for non-prescription drug-associated out-of-hospital cardiac arrest
AU - Aticha Amie Prasongsukarn
AU - Valerie Mok
AU - Jane Hsu
AU - Vivian Le
AU - Lovepreet Singh
AU - Jacob Hutton
AU - Frank Scheuermeyer
AU - Morgan Haines
AU - Chris Cartwright
AU - Rohan Hundal
AU - Jim Christenson
AU - Brian Grunau
PY - 2026
DA - 2026/10/08
JO - Resuscitation plus
DO - 10.1016/j.resplu.2026.101526
UR - https://europepmc.org/article/PMC/PMC13717888
AB - Introduction Non-prescription drug toxicity contributes to a substantial proportion of out-of-hospital cardiac arrests (OHCAs). Among OHCAs overall, previous reports have shown lower survival among females, compared to males. We examined sex-based differences in outcomes among non-prescription drug-associated OHCA (DA-OHCA).Methods In this population-based observational cohort study using data from the BC Cardiac Arrest Registry (2019-24), we included emergency medical services (EMS)-treated OHCAs that had evidence of recent non-prescription drug use. The primary outcome was favorable neurological outcome, and secondary outcomes included survival at hospital discharge, prehospital return of spontaneous circulation (ROSC), and ROSC at emergency department (ED) arrival. We assessed the association between female sex (vs male) and outcomes using multivariable logistic regression models, adjusted for Utstein variables.Results Among 47,051 EMS-Assessed OHCA, there were 4926 adult EMS-assessed DA-OHCA. We included 3133 adult EMS-treated DA-OHCAs, of whom 864 (28%) were female and 2269 (72%) were male, with a median age of 38 (interquartile range [IQR] 30-49) and 40 (IQR 32-52) years, respectively. Favorable neurological outcomes occurred in 108 (13%) females and 212 (9.6%) males. Female sex was not associated with favorable neurological outcome (adjusted odds ratio [aOR] 1.32, 95% CI 0.97, 1.79), prehospital ROSC (aOR 1.00, 95% CI 0.83, 1.19), or ROSC at ED arrival (aOR 1.01, 95% CI 0.84, 1.22), but was associated with an increased odds survival to hospital discharge (aOR 1.34; 95% CI 1.01, 1.77).Conclusions Among DA-OHCA, female sex was not independently associated with favorable neurological outcomes, but was associated with a higher odds of survival to hospital discharge.
SN - 2666-5204
ER -