Is There Gender Bias in Critical Care?

Alspach, JoAnn Grif

doi:10.4037/ccn2012727

Cited by 22 publications

(20 citation statements)

References 46 publications

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“…Men also had antibiotics administered in less time than women (from antibiotics ordered to administered: women M 80.1, SD 135.9 min; men M 59.2, SD 56.9 min; t = 2.1, p = .037), which supports the work of , who determined that women were less likely to receive antibiotics within 3 hr compared to men. Similarly, in an editorial by Alspach ( 2012 ), three studies were cited in which women with stroke had longer waiting times after arrival to the ED and received less aggressive workup and treatment than men. Prompt assessment, diagnosis, and medical intervention in sepsis-like symptoms is critical since each hour of delay in giving antibiotics to a patient with severe sepsis decreases the likelihood of survival by 7.6% (Kumar et al, 2006 ).…”

Section: Discussionmentioning

confidence: 99%

Does Gender Matter in Septic Patient Outcomes?

Failla

Connelly

Ecoff

et al. 2019

J of Nursing Scholarship

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Purpose The purpose of this study was to examine potential gender disparities in relation to factors associated with sepsis management among a cohort of patients admitted through an emergency department with a discharge diagnosis of severe sepsis or septic shock. Sepsis is one of the leading causes of death globally, with significant associated costs. Predictors of survival for those with sepsis‐related diagnoses are complex. Design and Methods The study had a retrospective, descriptive cross‐sectional design. The sample (N = 482) included patients 18 years of age or older who presented to the emergency department of a nonprofit, Magnet‐recognized, acute care hospital located in southern California. Subjects included those who subsequently met the criteria for a discharge diagnosis of severe sepsis or septic shock as defined by the Surviving Sepsis Campaign. Patient characteristics, clinical variables, care management processes, and outcomes were extracted from the electronic health record. A multivariate model was analyzed. Findings The sample included 234 women (48.5%) and 248 men (51.5%). Logistic regression with eight independent variables (discharge diagnosis, age, comorbidities, length of hospital stay, source of infection, first serum lactate level measured, recommended fluids administered, and gender) reliably predicted odds for patient survival, ϰ2 (12) = 118.38, p < .001, and correctly classified 77.3% of cases. All eight independent variables significantly contributed to the model. Men had a higher likelihood of hospital survival than women (odds ratio 1.68; 95% confidence interval 1.01–2.79; p = .045). Conclusions The Surviving Sepsis Campaign has provided a clear pathway for care of patients with sepsis‐related diagnoses. Therapeutic strategies should be developed to address differences in outcome by gender. The adoption of more aggressive applications of evidence‐based interventions for these patients may result in better patient outcomes. Clinical Relevance Providers should understand the importance of adhering to sepsis protocols, minimizing treatment disparities, and recognizing gender differences.

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Section: Discussionmentioning

confidence: 99%

Does Gender Matter in Septic Patient Outcomes?

Failla

Connelly

Ecoff

et al. 2019

J of Nursing Scholarship

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“…Most of the studies reported to date are limited by their retrospective designs, their lack of information on hormonal status, and the difficulty in controlling for other variables that can influence trauma. 39 …”

Section: Sex-based Differences In Trauma Outcomesmentioning

confidence: 99%

Gender-specific Issues in Traumatic Injury and Resuscitation: Consensus-based Recommendations for Future Research

Sethuraman

Marcolini

McCunn³

et al. 2014

Acad Emerg Med

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Traumatic injury remains an unacceptably high contributor to morbidity and mortality rates across the United States. Gender-specific research in trauma and emergency resuscitation has become a rising priority. In concert with the 2014 Academic Emergency Medicine consensus conference “Gender-specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes,” a consensus-building group consisting of experts in emergency medicine, critical care, traumatology, anesthesiology, and public health convened to generate research recommendations and priority questions to be answered and thus move the field forward. Nominal group technique was used for the consensus-building process and a combination of face-to-face meetings, monthly conference calls, e-mail discussions, and preconference surveys were used to refine the research questions. The resulting research agenda focuses on opportunities to improve patient outcomes by expanding research in sex- and gender-specific emergency care in the field of traumatic injury and resuscitation.

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“…The term 'gender bias' in medicine refers to clinically unjustified differences in diagnosis and treatment of male and female patients and most of the evidence suggests that women experience more difficulties for this reason [1, 4]. The disparities between sexes in medicine arise from many factors: differences in the way that men and women perceive and report their illness and symptoms, misjudgment of a woman's health risk, misperception of risks and benefits of particular medical procedures, unconscious prejudice and explicit discrimination of women, and cultural biases [5]. Consequently, gender bias in medicine results in sex-based inequities in access to and utilization of health services, leading to probable differences in men's and women's health responsiveness to medical care.…”

Section: Introductionmentioning

confidence: 99%

Gender bias and sex-based differences in health care efficiency in Polish regions

Łyszczarz

2017

Int J Equity Health

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BackgroundHealth differences between sexes are relatively well recognized, though less is known about the specificity of women's and men's health responsiveness to medical care. Applying data from Polish regions, this study identifies sex-based differences in medical care efficiency and investigates the reasons for these disparities in the gender bias context.MethodsThe study estimates sex-specific health production functions for regional data from Poland (1999–2013). Using panel-data regression, male and female life expectancies at ages 0, 15, 30, 45, 60 and 65 are regressed on a set of socioeconomic factors, with the primary interest in medical care proxied by doctor density.ResultsThe results show that in Poland the association between life expectancy and doctor density was positive for both men and women; however, the coefficients for medical care were insignificant for those at birth and at the age of 30 for both sexes. The magnitude of health care for longevity was higher for men comparing to women at every age, though the difference between sexes was not statistically significant. The sex-based disparities in medical care efficiency were more pronounced at younger ages and they diminished with age. The inspection of data on the health system in Poland shows that male patients seemed to be in an advantageous position: the mean reimbursement per service for men was higher in most medical care areas; men reported less problems with access to health care; and their mortality trend exhibited more favorable evolution over time. Additionally, the association between other socioeconomic factors and health also differed across sexes, and several of these factors were more important for life expectancy than health care.ConclusionPolish medical care suffers from gender bias, which possibly makes men more responsive to medical care. The disparities in the operation of medical care in Poland should be challenged to achieve more equal access to services between sexes and possibly to gain more health from the treatment of female patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0501-y) contains supplementary material, which is available to authorized users.

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Is There Gender Bias in Critical Care?

Cited by 22 publications

References 46 publications

Does Gender Matter in Septic Patient Outcomes?

Does Gender Matter in Septic Patient Outcomes?

Gender-specific Issues in Traumatic Injury and Resuscitation: Consensus-based Recommendations for Future Research

Gender bias and sex-based differences in health care efficiency in Polish regions

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