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Background  It remains unclear whether men have more favorable survival outcomes after out-of-hospital cardiac arrest (OHCA) than women.    Methods  We reviewed a total of 386,535 patients aged ≥ 18 years with OHCA who were included in the Japanese registry from 2013 to 2016. The study endpoints were the rates of 1-month survival and neurologically intact survival (Cerebral Performance Category Scale score = 1 or 2). Based on age, the reviewed patients were categorized into the following eight groups: < 30, 30–39, 40–49, 50–59, 60–69, 70–79, 80–89, and ≥ 90 years. The survival outcomes in men and women were compared using hierarchical propensity score matching.    Results  The crude survival rate was significantly higher in men than in women in five groups: 30–39, 40–49, 50–59, 60–69, and 70–79 years (all  P  < 0.001). Similarly, the crude neurologically intact survival rate was significantly higher in men than in women in seven groups: < 30, 30–39, 40–49, 50–59, 60–69, 70–79, and 80–89 years (all  P  < 0.005). However, multivariate logistic regression analysis of each group revealed no significant sex-specific differences in 1-month survival outcomes (all  P  > 0.02). Moreover, after hierarchical propensity score matching, the survival outcomes did not significantly differ between both sexes (all  P  > 0.05).    Conclusions  No significant sex-specific differences were found in the rates of 1-month survival and neurologically intact survival after OHCA.    Electronic supplementary material  The online version of this article (10.1186/s13054-019-2547-x) contains supplementary material, which is available to authorized users.

Sex-specific differences in survival after out-of-hospital cardiac arrest: a nationwide, population-based observational study