Sex-specific outcomes and management in critically ill septic patients

Background: : Female and male critically ill septic patients might differ with regards to risk distribution, management, and outcomes. We aimed to compare male versus female septic patients in a large collective with regards to baseline risk distribution and outcomes. Methods: : In total, 17,146 patients were included in this analysis, 8781 (51%) male and 8365 (49%) female patients. The primary endpoint was ICU-mortality. Baseline characteristics and data on organ support were documented. Multilevel logistic regression analyses were used to assess sex-specific differences. Results: : Female patients had lower SOFA scores (5 +/- 5 vs. 6 +/- 6; p <0.001) and creatinine (1.20 +/- 1.35 vs. 1.40 +/- 1.54; p < 0.001). In the total cohort, the ICU mortality was 10% and similar between female and male (10% vs. 10%; p = 0.34) patients. The ICU remained similar between sexes after adjustment in model-1 (aOR 1.05 95% CI 0.95-1.16; p = 0.34); model-2 (aOR 0.91 95% CI 0.79-1.05; p = 0.18) and model-3 (aOR 0.93 95% CI 0.80-1.07; p = 0.29). In sensitivity analyses, no major sex-specific differences in mortality could be detected. Conclusion: : In this study no clinically relevant sex-specific mortality differences could be detected in critically ill septic patients. Possible subtle gender differences could play a minor role in the acute situation due to the severity of the disease in septic patients.

Automated summary

The study compared critically ill septic male and female patients and found no clinically relevant differences in ICU mortality. Female patients had slightly lower biochemical indicators compared to males, but overall mortality and ICU length of stay were similar between the two sexes.