Chest
Original ResearchCritical Care MedicineInfluence of Gender on the Outcome of Severe Sepsis: A Reappraisal
Section snippets
Study Design and Data Source
We conducted a prospective observational study in a multicenter database (OutcomeRea; Rosny-sous-Bois, France) from January 1997 to September 2005. The database, fed by 12 French ICUs, contains data on daily disease severity, iatrogenic events, and nosocomial infections. A random sample of at least 50 patients > 16 years old and having ICU stays > 24 h was entered into the database each year. Each participating ICU chose to perform random sampling by taking either consecutive admissions in
Study Population
Of the 4,860 patients included in the database (all with ICU stays > 48 h), 1,692 met our criteria for severe sepsis; 63% were male and 37% were female (Fig 1). The women were older and had a higher rate of emergency surgery, lower organ dysfunction scores (LOD and sequential organ failure assessment), and similar SAPS II scores at hospital admission (Table 1). Chronic pulmonary dysfunction as assessed by Knaus definitions was more common in male patients, but all other comorbidities were
Discussion
Mortality from severe sepsis was higher in men than in women, after adjustment for confounding factors. This difference was due to higher mortality in men > 50 years old compared to same-age (postmenopausal) women; mortality was not significantly different between younger men and women. The level of care and rate of invasive procedures were similar in women and men.
Our findings agree with previous data showing a higher incidence of sepsis in men12 compared to women. Numerous studies138910111213
Scientific Committee:
Jean-François Timsit (Hôpital Albert Michallon and INSERM U823, Grenoble, France); Pierre Moine (Surgical ICU, Denver, CO); Arnaud De Lassence (ICU, Hôpital Louis Mourier, Combes, France); Elie Azoulay (Medical ICU, Hôpital Saint Louis, Paris, France); Yves Cohen (ICU, Hôpital Avicenne, Bobigny, France); Maïté Garrouste-Orgeas (ICU Hôpital Saint-Joseph, Paris, France); Lilia Soufir (ICU, Hôpital Saint-Joseph, Paris, France); Jean-Ralph Zahar (Microbiology Department, Hôpital Necker, Paris,
Acknowledgments
We are indebted to A. Wolfe, MD, for helping with this manuscript.
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OutcomeRea is supported by nonexclusive educational grants from Aventis Pharma, France, and Wyeth, as well as by public funds from the Centre National de la Recherche Scientifique.
The authors have no conflicts of interest to disclose.