The following is a summary of “Sex disparities in ICU care and outcomes after cardiac arrest: a Swiss nationwide analysis,” published in the January 2025 issue of Critical Care by Amacher et al. 

Researchers conducted a retrospective study to investigate sex disparities in the provision of critical care and outcomes for in-hospital (IHCA) and out-of-hospital (OHCA) patients with cardiac arrest.  

They analyzed data from adult patients with cardiac arrest admitted to certified Swiss intensive care units (ICUs) between January 2008 and December 2022, using the nationwide prospective ICU registry. The primary outcome was ICU mortality, while secondary outcomes included the likelihood of ICU admission and the provision of advanced treatments.  

The results showed that among 41,733 individuals (34.9% women), 21,692 patients (30.6% women) were admitted to ICUs, including 16,571 OHCA and 5,121 patients of IHCA. Women were less likely to be admitted (incidence rate ratio 0.82 [95% CI 0.80–0.85]) and had higher ICU mortality (41.8% vs 36.2%; P < 0.001). Mortality differences were more pronounced in patients of OHCA (unadjusted hazard ratio [HR]: 1.35 [95% CI 1.28–1.43]; adjusted HR: 1.19 [95% CI 1.12–1.25]), while in patients of IHCA , the differences were smaller (unadjusted HR: 1.14 [95% CI 1.04–1.25]) and disappeared after adjusting for confounders (adjusted HR: 1.03 [95% CI 0.94–1.13]). Women 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 found that treatment limitations were more frequent in women (46.7% vs 38.7%; P < 0.001), and these limitations were linked to higher mortality in both sexes.  

Investigators concluded the sex disparities in short-term mortality and ICU resource allocation were observed among patients with cardiac arrest, and women facing potential disadvantages, especially after OHCA. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05262-5