Gender differences in outcome and use of resources do exist in Swedish intensive care, but to no advantage for women of premenopausal age
Open Access
- 30 March 2015
- journal article
- research article
- Published by Springer Science and Business Media LLC in Critical Care
- Vol. 19 (1), 1-9
- https://doi.org/10.1186/s13054-015-0873-1
Abstract
Introduction Preclinical data indicate that oestrogen appears to play a beneficial role in the pathophysiology of and recovery from critical illness. In few previous epidemiologic studies, however, have researchers analysed premenopausal women as a separate group when addressing potential gender differences in critical care outcome. Our aim was to see if women of premenopausal age have a better outcome following critical care and to investigate the association between gender and use of intensive care unit (ICU) resources. Methods On the basis of our analysis of 127,254 consecutive Simplified Acute Physiology Score III–scored Swedish Intensive Care Registry ICU admissions from 2008 through 2012, we determined the risk-adjusted 30-day mortality, accumulated nurse workload score and ICU length of stay. To investigate associations with sex, we used logistic regression and multivariate analyses on the entire cohort as well as on two subgroups stratified by median age for menopause (up to and including 45 years and older than 45 years) and six selected diagnostic subgroups (sepsis, multiple trauma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, pneumonia and cardiac arrest). Results There was no sex difference in risk-adjusted mortality for the cohort as a whole, and there was no sex difference in risk-adjusted mortality in the group 45 years of age and younger. For the group of patients older than 45 years of age, we found a reduced risk-adjusted mortality in men admitted for cardiac arrest. For the cohort as a whole, and for those admitted with multiple trauma, male sex was associated with a higher nurse workload score and a longer ICU stay. Conclusions Using information derived from a large multiple ICU register database, we found that premenopausal female sex was not associated with a survival advantage following intensive care in Sweden. When the data were adjusted for age and severity of illness, we found that men used more ICU resources per admission than women did.Keywords
This publication has 56 references indexed in Scilit:
- Association of gender with outcomes in critically ill patientsCritical Care, 2012
- Testosterone Depletion or Blockade in Male Rats Protects Against Trauma Hemorrhagic Shock-Induced Distant Organ Injury by Limiting Gut Injury and Subsequent Production of Biologically Active Mesenteric LymphThe Journal of Trauma and Acute Care Surgery, 2011
- Gender and Acute Respiratory Distress Syndrome in Critically Injured Adults: A Prospective StudyThe Journal of Trauma and Acute Care Surgery, 2011
- Trends in Estradiol During Critical Illness Are Associated with Mortality Independent of Admission EstradiolJournal of the American College of Surgeons, 2011
- Gender differences in mortality in patients with severe sepsis or septic shockGender Medicine, 2010
- Does Gender Impact Intensity of Care Provided to Older Medical Intensive Care Unit Patients?Critical Care Research and Practice, 2010
- Variations in the length of stay of intensive care unit nonsurvivors in three scandinavian countriesCritical Care, 2010
- Hormonally Active Women Tolerate Shock-Trauma Better Than Do MenAnnals of Surgery, 2007
- SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admissionIntensive Care Medicine, 2005
- SAPS 3—From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort descriptionIntensive Care Medicine, 2005