ASSOCIATION OF SEX WITH CLINICAL OUTCOME IN CRITICALLY ILL SEPSIS PATIENTS: A RETROSPECTIVE ANALYSIS OF THE LARGE CLINICAL DATABASE MIMIC-III

被引:47
|
作者
Xu, Jinghong [1 ,2 ]
Tong, Li [1 ]
Yao, Jiyou [1 ,3 ]
Guo, Zilu [4 ]
Lui, Ka Yin [1 ]
Hu, XiaoGuang [1 ]
Cao, Lu [5 ]
Zhu, Yanping [1 ]
Huang, Fa [1 ,3 ]
Guan, Xiangdong [1 ]
Cai, Changjie [1 ]
机构
[1] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Crit Care Med, 58,Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, Peoples R China
[2] Minist Hlth, Key Lab Assisted Circulat, Guangzhou, Guangdong, Peoples R China
[3] Guangdong Prov Key Lab Organ Donat & Transplant I, Guangzhou, Guangdong, Peoples R China
[4] William March Rice Univ, Dept Stat, Houston, TX USA
[5] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Extracorporeal Circulat, Guangzhou, Guangdong, Peoples R China
来源
SHOCK | 2019年 / 52卷 / 02期
关键词
Big data analytics; gender; medical information mart for intensive care; mortality; septic patients; INTENSIVE-CARE-UNIT; MORTALITY; ESTROGEN; GENDER; CONSEQUENCES; INFECTION;
D O I
10.1097/SHK.0000000000001253
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction: The objective of our study was to explore the association between sex and clinical outcome in sepsis patients in a large, diverse population. Materials and Methods: We analyzed 6,134 adult patients with sepsis from the critical care units of Beth Israel Deaconess Medical Center between 2001 and 2012. Study data were retrospectively extracted from Medical Information Mart for Intensive Care-III, a multiparameter intensive care database. Results: There were 2,677 (43.6%) female and 3,457 (56.4%) male patients. Compared with female patients, male patients with sepsis had a higher 1-year mortality rate (55.6% vs. 51.4%, P = 0.001), and so did the 90-day mortality rate (45.1% vs. 42.1%, P = 0.018). 33.8% of male and 31.3% of female patients with sepsis died during hospitalization (P = 0.041). The median length of hospitalization and intensive care unit (ICU) stay for male patients was 19.54 and 7.54 days, while that for female patients was 16.49 and 6.75 days (P< 0.001, P = 0.002, respectively). Male patients were more likely to require dialysis therapy (P = 0.109), ventilation support (P = 0.012) and more vasoactive agents (dopamine P = 0.113, norepinephrine P = 0.016, and epinephrine P =' 0.093) during the ICU period than female patients. Our Cox proportional hazard regression model confirmed that the risk of death within 1 year of ICU admission in male patients is 1.083 times that in female. Conclusion: Female patients with sepsis have better clinical outcomes than male patients in terms of mortality and length of hospitalization and ICU stay.
引用
收藏
页码:146 / 151
页数:6
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