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Association between sex and mortality in patients with sepsis admitted to the ICU: gender and sex hormones influence the response to sepsis?
Critical Care volume 13, Article number: P19 (2009)
Studies have demonstrated an impact of gender dimorphism on immune and organ responsiveness and in the susceptibility to and morbidity from shock, trauma, and sepsis. We performed a comparative analysis of mortality in two subgroups of patients with sepsis, differentiated by age and sex, admitted to the ICU (UTI) of a teaching hospital.
From December 2005 to April 2008, 97 patients admitted to the ICU with a diagnosis of sepsis were separated into two subgroups based on age: (G1) the subgroup aged 14 to 40 years old, and the other subgroup (G2) aged over 50 years old. The subgroups were characterized for the demographic data, prognostic indicators (APACHE II score, organ dysfunction at admission and circulatory shock) and outcome (mortality).
The G1 subgroup (n = 35) had 22 (62.9%) female patients and the G2 subgroup (n = 62) had 34 (54.8%) female patients. The mean APACHE II scores were not statistically different between female and male patients of G1 (21.0 ± 9.3 vs 24.8 ± 6.1 points, P = 0.21) and of G2 (23.8 ± 6.6 vs 24.4 ± 9.3 points, P = 0.8) subgroups. There was no statistically significant difference in the incidence of multiple organ dysfunctions (P = 0.89) or progression to circulatory shock (P = 0.46) among females and males in the two subgroups. The general mortality rate was lower in female than in male patients from the G1 subgroup; a reverse trend was observed in subgroup G2 (Figure 1).
Females under 40 years old, in the fertile period, had lower mortality than males in sepsis, and there was a trend to lower mortality in men over 50 years old, possibly due to dimorphism in immune and organ responsiveness related to sex and age.
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Peixoto, A., Couto, D., Sales, D. et al. Association between sex and mortality in patients with sepsis admitted to the ICU: gender and sex hormones influence the response to sepsis?. Crit Care 13 (Suppl 3), P19 (2009). https://doi.org/10.1186/cc7821