Abstract
Background
At present, there have been studies showing a correlation between sex differences and prognosis. Nevertheless, the evidence of short- and long-term survival of sex-based differences among critically ill patients with sepsis is still limited and controversial. The purpose of this study was to evaluate the effect of sex on the short- and long-term survival of critically ill patients with sepsis.
Methods
We used the Medical Information Mart for Intensive Care III database. Cox proportional hazards models were conducted to determine the relationship of 28-day and 1-year mortality rates with a different sex. Interaction and stratified analyses were conducted to test whether the effect of sex differed across various subgroups.
Results
A total of 12,321 patients were enrolled in this study. After adjustments, the 28-day and 1-year mortality rates for female patients were reduced by 12% and 10%, respectively (HR = 0.88, 95% CI 0.81–0.96 and HR = 0.90, 95% CI 0.85–0.95) when compared to male patients. The effects of the association between sex and 28-day and 1-year mortality were broadly consistent for all subgroup variables. Only a significant interaction of age was observed in 1-year mortality (P = 0.0091). Compared with male patients, female patients (< 50 years) had better long-term survival advantages (HR 0.76 95% CI 0.62–0.94, P = 0.0124); on the contrary, for older patients (≥ 50 years), we did not find sex-based differences in long-term survival (HR 1.03, 95% CI 0.97–1.09, P = 0.3678).
Conclusions
In the current retrospective large database review, female patients had a significantly lower 28-day and 1-year mortality rates than did males among critically ill patients with sepsis. Of concern, there was an interaction between age and sex, and whether to suggest that female-associated hormones affect clinical outcomes needs to be further researched.
Sex Differences in Short- and Long-Term Survival Among Critically Ill Patients with Sepsis
