PT  - JOURNAL ARTICLE
AU  - Robin L A Smits
AU  - Laura H van Dongen
AU  - Marieke T Blom
AU  - Hanno L Tan
AU  - Irene G M van Valkengoed
TI  - Gender-related factors and out-of-hospital cardiac arrest incidence in women and men: analysis of a population-based cohort study in the Netherlands
AID  - 10.1136/jech-2021-218329
DP  - 2022 Sep 01
TA  - Journal of Epidemiology and Community Health
PG  - 800--808
VI  - 76
IP  - 9
4099  - http://jech.bmj.com/content/76/9/800.short
4100  - http://jech.bmj.com/content/76/9/800.full
SO  - J Epidemiol Community Health2022 Sep 01; 76
AB  - Background The incidence of out-of-hospital cardiac arrest (OHCA) differs consistently between women and men. Besides sex-related (biological) factors, OHCA risk may relate to gender-related (sociocultural) factors. We explored the association of selected gender-related factors with OHCA incidence in women and men.Methods We combined data on emergency medical services-attended OHCA with individual-level data from all women and men aged ≥25 years living in North Holland, the Netherlands. We estimated the associations between employment status, primary earner status, living with children and marital status and the OHCA incidence with Cox proportional hazards models stratified by sex and adjusted for age and socioeconomic status. To determine if metabolic factors explain the associations, we added hypertension, diabetes mellitus and dyslipidaemia to the models. Population attributable fractions (PAF) for all gender-related factors were calculated.Results All four gender-related factors were associated with OHCA incidence (eg, unemployed vs employed; HR 1.98, 95% CI 1.67 to 2.35 in women; HR 1.60, 95% CI 1.44 to 1.79 in men). In both sexes, those unemployed, those who are not primary earners, those living without children, and married or divorced individuals had an increased OHCA risk. The PAF ranged from 4.9 to 40.3 in women and from 4.4 to 15.5 in men, with the highest PAF for employment status in both sexes. Metabolic risk factors did not explain the observed associations.Conclusion Gender-related factors were associated with risk of OHCA and contributed substantially to the OHCA burden at the population level, particularly in women. Employment status contributed most to the OHCA burden.No data are available. The data underlying this article are available in the article and in its online supplemental materials. The data cannot be shared publicly for privacy of individuals who participated in the study as data cannot be provided completely anonymous according to the Medical Ethics Committee and the Data Protection Officer of our institution (MEC: mecamc@amc.nl, DPO: fg@amc.nl).