Effect of Patient Sex on Intensive Care Unit Survival

Romo, Hugo; Amaral, Andre Carlos Kajdacsy-Balla; Vincent, Jean‐Louis

doi:10.1001/archinte.164.1.61

Cited by 54 publications

(47 citation statements)

References 48 publications

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“…Similar findings have been reported previously, 2,7,13 although some controversy remains. [14][15][16] The reasons women may have a higher mortality than men during a critical illness are poorly understood, and clinical studies [17][18][19] have shown that women have higher mortality rates than men do despite biological evidence of the protective effect of estrogens on both immune function and cardiovascular responses.…”

Section: Discussionsupporting

confidence: 90%

Sex and Mortality of Hospitalized Adults After Admission to an Intensive Care Unit

Lipes

Mardini

Jayaraman

2013

American Journal of Critical Care

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Background After admission to intensive care, women have higher mortality rates than do men. The reasons for the greater mortality in women are not fully understood. Objective To determine if increased mortality in women was due to delays in the recognition of critical illness or to delays in timely admission to intensive care. Methods A total of 241 consecutive admissions to intensive care from medical and surgical units during a 12-month period were analyzed retrospectively. Patients' demographics, illness severity, and delay between the time the patients would have fulfilled criteria for calling a medical emergency team and consultation with and admission to intensive care were analyzed. Results Delay from fulfillment of criteria for calling a medical emergency team and consultation with intensive care and from consultation to admission to intensive care did not differ between sexes. Despite similar delays in admission to intensive care, women had a higher 30-day mortality than did men (44.9% vs 30.5%; P = .02). The increased mortality was more pronounced in the medical patients (53% vs 34%; P = .02). Multivariate analysis of mortality data yielded a mortality odds ratio of 0.35 (95% CI, 0.16-0.74) for men, significantly different from values for women (P = .006). Conclusion After admission to intensive care from medical or surgical units, women had higher mortality rates than did men, and the difference was more pronounced in medical patients.

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Section: Discussionsupporting

confidence: 90%

Sex and Mortality of Hospitalized Adults After Admission to an Intensive Care Unit

Lipes

Mardini

Jayaraman

2013

American Journal of Critical Care

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“…This age-sex relation is consistent with findings from smaller studies. 4,23 In previous studies, sex-related differences in outcomes among critically ill patients receiving mechanical ventilation were attenuated after adjustment for severity of illness;…”

mentioning

confidence: 97%

Sex-and age-based differences in the delivery and outcomes of critical care

Fowler¹,

Sabur²,

Li³

et al. 2007

Canadian Medical Association Journal

259

193

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“…[1][2][3][4][5][6] The relationship between gender and outcomes after critical injury in humans remains unclear despite multiple observational studies. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] Most studies have been unable to detect a difference in overall survival, even when adequately powered. 7,8,10,[12][13][14][15]18 An important difference between humans and animal models with regards to sexual dimorphism is the unique mechanisms of estrogen biosynthesis during stress that is present in humans (and other primates).…”

mentioning

confidence: 99%

High Levels of Endogenous Estrogens are Associated With Death in the Critically Injured Adult

Dossett

Swenson

Heffernan

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Background: Sex hormones exhibit predictable changes in their physiologic patterns during critical illness. Endogenous estrogens are elevated in both genders as a result of the peripheral conversion of androgens to estrogens by the aromatase enzyme. Elevated endogenous estrogens have been associated with death in medical and mixed surgical intensive care unit (ICU) patients. Our objective was to determine the relationship between endogenous estrogens and outcomes in critically injured patients.

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Effect of Patient Sex on Intensive Care Unit Survival

Abstract: In a mixed medical-surgical ICU, older women have a higher mortality rate than men. This difference is not apparent for patients staying longer in the ICU.

Cited by 54 publications

References 48 publications

Sex and Mortality of Hospitalized Adults After Admission to an Intensive Care Unit

Sex and Mortality of Hospitalized Adults After Admission to an Intensive Care Unit

Sex-and age-based differences in the delivery and outcomes of critical care

High Levels of Endogenous Estrogens are Associated With Death in the Critically Injured Adult

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