TY - JOUR
T1 - Sex differences in long-term survival after intensive care unit treatment for sepsis
T2 - A cohort study
AU - Thompson, Kelly
AU - Hammond, Naomi
AU - Bailey, Michael
AU - Darvall, Jai
AU - Low, Gary
AU - McGloughlin, Steven
AU - Modra, Lucy
AU - Pilcher, David
N1 - Publisher Copyright:
© 2023 Thompson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2023/2
Y1 - 2023/2
N2 - Objective To determine the effect of sex on sepsis-related ICU admission and survival for up to 3-years. Methods Retrospective cohort study of adults admitted to Australian ICUs between 2018 and 2020. Men and women with a primary diagnosis of sepsis were included. The primary outcome of time to death for up to 3-years was examined using Kaplan Meier plots. Secondary outcomes included the duration of ICU and hospital stay. Results Of 523,576 admissions, there were 63,039 (12.0%) sepsis-related ICU admissions. Of these, there were 50,956 patients (43.4% women) with 3-year survival data. Men were older (mean age 66.5 vs 63.6 years), more commonly received mechanical ventilation (27.4% vs 24.7%) and renal replacement therapy (8.2% vs 6.8%) and had worse survival (Hazard Ratio [HR] 1.11; 95% Confidence Interval [CI] 1.07 to 1.14, P<0.001) compared to women. The duration of hospital and ICU stay was longer for men, compared to women (median hospital stay, 9.8 vs 9.4 days; p<0.001 and ICU stay, 2.7 vs 2.6 days; p<0.001). Conclusion Men are more likely to be admitted to ICU with sepsis and have worse survival for up to 3-years. Understanding causal mechanisms of sex differences may facilitate the development of targeted sepsis strategies.
AB - Objective To determine the effect of sex on sepsis-related ICU admission and survival for up to 3-years. Methods Retrospective cohort study of adults admitted to Australian ICUs between 2018 and 2020. Men and women with a primary diagnosis of sepsis were included. The primary outcome of time to death for up to 3-years was examined using Kaplan Meier plots. Secondary outcomes included the duration of ICU and hospital stay. Results Of 523,576 admissions, there were 63,039 (12.0%) sepsis-related ICU admissions. Of these, there were 50,956 patients (43.4% women) with 3-year survival data. Men were older (mean age 66.5 vs 63.6 years), more commonly received mechanical ventilation (27.4% vs 24.7%) and renal replacement therapy (8.2% vs 6.8%) and had worse survival (Hazard Ratio [HR] 1.11; 95% Confidence Interval [CI] 1.07 to 1.14, P<0.001) compared to women. The duration of hospital and ICU stay was longer for men, compared to women (median hospital stay, 9.8 vs 9.4 days; p<0.001 and ICU stay, 2.7 vs 2.6 days; p<0.001). Conclusion Men are more likely to be admitted to ICU with sepsis and have worse survival for up to 3-years. Understanding causal mechanisms of sex differences may facilitate the development of targeted sepsis strategies.
UR - https://www.scopus.com/pages/publications/85148906959
U2 - 10.1371/journal.pone.0281939
DO - 10.1371/journal.pone.0281939
M3 - Article
C2 - 36827250
AN - SCOPUS:85148906959
SN - 1932-6203
VL - 18
JO - PLoS ONE
JF - PLoS ONE
IS - 2 February
M1 - e0281939
ER -