This study examined gender disparities in receipt of bystander CPR after witnessed out-of-hospital cardiac arrests (OHCA) of presumed cardiac etiology in Japan (2005–2023), stratifying by patient age group (≤14, 15–49, 50–64, 65–74, ≥75 years) and bystander category (e.g., family, friends/colleagues, passersby, staff/related personnel).
Among 453,441 patients, females overall were *more* likely to receive bystander CPR than males (adjusted OR 1.100, 95% CI 1.084–1.113), but females aged 15–64 were *less* likely to receive CPR when bystanders were friends, colleagues, or passersby. Bystander category had a far stronger association with CPR receipt (OR 3.555 for staff/related personnel vs. family, 95% CI 3.500–3.611) than patient gender.
- Registry data may lack granularity on reasons CPR was withheld (e.g., do-not-resuscitate orders, bystander training status). - The study is observational; causality cannot be established. - "Gender" is based on registry classification, which may not capture full diversity.
CPR training and public health campaigns should focus on overcoming hesitancy to perform CPR on women in non-family settings (e.g., workplaces, public spaces), particularly for women aged 15–64. Bystander category — not patient gender — is the dominant driver of CPR receipt disparities.
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