Lack of Influence of Gender on Outcomes of Mechanically Ventilated Medical ICU Patients
- 1 September 1999
- journal article
- Published by Elsevier BV in Chest
- Vol. 116 (3), 732-739
- https://doi.org/10.1378/chest.116.3.732
Abstract
Recent studies combining medical and surgical patients have suggested that mortality is higher for mechanically ventilated women than for men. This study was designed to determine whether there are gender-based differences in outcomes in mechanically ventilated medical ICU (MICU) patients. Prospective observational study in an MICU of a tertiary-care academic medical center. Five hundred eighty consecutive patients admitted to the MICU service and mechanically ventilated for a minimum of 12 h. There was no difference in overall hospital mortality rate (woman, 36.3%; men, 40.4%; p > 0.2). No differences in mortality rates were noted after stratification based on age, underlying comorbid condition, APACHE (acute physiology and chronic health evaluation) II score, indication for mechanical ventilation, or acute hepatic or renal failure. Using a multiple logistic regression model, gender was not independently associated with hospital mortality. No differences were found between men and women for a number of secondary outcomes, including likelihood of undergoing weaning trials, success of weaning trials, time between onset of mechanical ventilation and extubation, total time on mechanical ventilation, rate of unplanned extubations, need for reintubation or tracheostomy, or duration of MICU and hospital stay, after the onset of mechanical ventilation. The number and timing of orders written to withhold care were comparable between men and women. Using univariate and multivariate analyses, we found no differences in hospital mortality rates between mechanically ventilated men and women. Differences in the process of care or gender-based treatment bias may explain previously reported differences in outcomes.This publication has 12 references indexed in Scilit:
- Influence of race and gender on care process, resource use, and hospital-based outcomes in congestive heart failureThe American Journal of Cardiology, 1998
- Hospital Mortality in Women and Men With Acute Cardiac Ischemia: A Prospective Multicenter StudyJournal of the American College of Cardiology, 1997
- The Impact of Gender on Outcome From Mechanical VentilationChest, 1997
- The risk of coronary artery surgery in women: A matched comparison using preoperative severity of illness scoringJournal of Cardiothoracic and Vascular Anesthesia, 1996
- Influence of gender on short- and long-term mortality after acute myocardial infarctionThe American Journal of Cardiology, 1996
- Determinants of operative mortality in reoperative coronary artery bypass graftingThe Journal of Thoracic and Cardiovascular Surgery, 1995
- Perioperative Mortality of Elective Abdominal Aortic Aneurysm SurgeryArchives of Internal Medicine, 1995
- Referral Patterns for Coronary Artery Disease Treatment: Gender Bias or Good Clinical Judgment?Annals of Internal Medicine, 1992
- Influence of age on outcome of mechanically ventilated patients in an intensive care unitCritical Care Medicine, 1992
- A Prospective Study of Acute Hypoxic Respiratory FailureChest, 1986