Does Gender Influence Surgical ICU Outcomes Related to Sepsis?

Impact of gender on severe infections is in highly controversial discussion with natural survival advantage of females described in animal studies but contradictory to human data. Irit Nachtigall, of the Department of Anesthesiology and Intensive Care at Charité Universitaetsmedizin Berlin, and colleagues, sought to describe impact of gender on outcome in mixed intensive care units (ICU) with a special focus on sepsis.

The researchers conducted a prospective, observational clinical trial at Charite university hospital in Berlin, Germany. Over 180 days patients were screened undergoing care in three mainly surgical ICUs. Seven hundred nine adults were included into analysis comprising the main population ([female] n=309, [male] n=400) including 327 as sepsis subgroup ([female] n=130, [male] n=197).

Basic characteristics differed between genders in terms of age, lifestyle factors, comorbidities and SOFA-score (Sequential Organ Failure Assessment). Quality and quantity of antibiotic therapy in means of antibiotic free days, daily antibiotic usage, daily costs of antibiotics, time to antibiotics and guideline adherence did not differ between genders. ICU mortality was comparable in the main population ([female] 10.7% versus [male] 9.0 %, p=0.523), but differed significantly in sepsis patients with [female] 23.1% versus [male] 13.7% (p=0.037). This was confirmed in multivariate regression analysis with OR = 1.966 (95%-CI: 1.045 - 3.701, p = 0.036) for females compared to males.

Nachtigall, et al. conclude that there were no differences in patients' outcome related to gender aspects on mainly surgical ICUs; however, for patients suffering from sepsis there is an increase of mortality related to the female sex. Their research was published in Critical Care.

Reference: Nachtigall T, Tafelski S, Rothbart A, Kaufner L, Schmidt M, Tamarkin A, Kartachov M, Zebedies D, Trefzer T, Wernecke KD and Spies C. Gender related outcome difference is related to course of sepsis on mixed ICUs - a prospective, observational clinical study. Critical Care 2011, 15:R151doi:10.1186/cc10277