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Sex differences in long-term survival after intensive care unit treatment for sepsis: A cohort study
To determine the effect of sex on sepsis-related ICU admission and survival for up to 3-years. Retrospective cohort study of adults admitted to Australian ICUs between 2018 and 2020. Men and women with a primary diagnosis of sepsis were included. The primary outcome of time to death for up to 3-year...
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Published in: | PloS one 2023-02, Vol.18 (2), p.e0281939-e0281939 |
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creator | Thompson, Kelly Hammond, Naomi Bailey, Michael Darvall, Jai Low, Gary McGloughlin, Steven Modra, Lucy Pilcher, David |
description | To determine the effect of sex on sepsis-related ICU admission and survival for up to 3-years.
Retrospective cohort study of adults admitted to Australian ICUs between 2018 and 2020. Men and women with a primary diagnosis of sepsis were included. The primary outcome of time to death for up to 3-years was examined using Kaplan Meier plots. Secondary outcomes included the duration of ICU and hospital stay.
Of 523,576 admissions, there were 63,039 (12·0%) sepsis-related ICU admissions. Of these, there were 50,956 patients (43·4% women) with 3-year survival data. Men were older (mean age 66·5 vs 63·6 years), more commonly received mechanical ventilation (27·4% vs 24·7%) and renal replacement therapy (8·2% vs 6·8%) and had worse survival (Hazard Ratio [HR] 1·11; 95% Confidence Interval [CI] 1·07 to 1·14, P |
doi_str_mv | 10.1371/journal.pone.0281939 |
format | article |
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Retrospective cohort study of adults admitted to Australian ICUs between 2018 and 2020. Men and women with a primary diagnosis of sepsis were included. The primary outcome of time to death for up to 3-years was examined using Kaplan Meier plots. Secondary outcomes included the duration of ICU and hospital stay.
Of 523,576 admissions, there were 63,039 (12·0%) sepsis-related ICU admissions. Of these, there were 50,956 patients (43·4% women) with 3-year survival data. Men were older (mean age 66·5 vs 63·6 years), more commonly received mechanical ventilation (27·4% vs 24·7%) and renal replacement therapy (8·2% vs 6·8%) and had worse survival (Hazard Ratio [HR] 1·11; 95% Confidence Interval [CI] 1·07 to 1·14, P<0·001) compared to women. The duration of hospital and ICU stay was longer for men, compared to women (median hospital stay, 9.8 vs 9.4 days; p<0.001 and ICU stay, 2.7 vs 2.6 days; p<0.001).
Men are more likely to be admitted to ICU with sepsis and have worse survival for up to 3-years. Understanding causal mechanisms of sex differences may facilitate the development of targeted sepsis strategies.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0281939</identifier><identifier>PMID: 36827250</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Age groups ; Aged ; Analysis ; Australia ; Care and treatment ; Chronic fatigue syndrome ; Cohort analysis ; Cohort Studies ; Confidence intervals ; Demographic aspects ; Female ; Frailty ; Gender differences ; Health risks ; Hospital Mortality ; Humans ; Infection ; Infections ; Intensive care ; Intensive Care Units ; Length of Stay ; Male ; Mechanical ventilation ; Medicine and Health Sciences ; Men ; Mortality ; Patient admissions ; People and Places ; Physical Sciences ; Physiology ; Retrospective Studies ; Sepsis ; Severe acute respiratory syndrome coronavirus 2 ; Sex Characteristics ; Sex differences ; Socioeconomic factors ; Survival ; Ventilation ; Women ; Womens health</subject><ispartof>PloS one, 2023-02, Vol.18 (2), p.e0281939-e0281939</ispartof><rights>Copyright: © 2023 Thompson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Thompson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Thompson et al 2023 Thompson et al</rights><rights>2023 Thompson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-6516a9833aa1fa9f1c8fba4184638026eb8bedd40d31606ef6c67ea75fe62bcc3</citedby><cites>FETCH-LOGICAL-c692t-6516a9833aa1fa9f1c8fba4184638026eb8bedd40d31606ef6c67ea75fe62bcc3</cites><orcidid>0000-0003-2304-8931 ; 0000-0001-7364-8316 ; 0000-0002-0062-3705</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2779729831/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2779729831?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36827250$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lazzeri, Chiara</contributor><creatorcontrib>Thompson, Kelly</creatorcontrib><creatorcontrib>Hammond, Naomi</creatorcontrib><creatorcontrib>Bailey, Michael</creatorcontrib><creatorcontrib>Darvall, Jai</creatorcontrib><creatorcontrib>Low, Gary</creatorcontrib><creatorcontrib>McGloughlin, Steven</creatorcontrib><creatorcontrib>Modra, Lucy</creatorcontrib><creatorcontrib>Pilcher, David</creatorcontrib><title>Sex differences in long-term survival after intensive care unit treatment for sepsis: A cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To determine the effect of sex on sepsis-related ICU admission and survival for up to 3-years.
Retrospective cohort study of adults admitted to Australian ICUs between 2018 and 2020. Men and women with a primary diagnosis of sepsis were included. The primary outcome of time to death for up to 3-years was examined using Kaplan Meier plots. Secondary outcomes included the duration of ICU and hospital stay.
Of 523,576 admissions, there were 63,039 (12·0%) sepsis-related ICU admissions. Of these, there were 50,956 patients (43·4% women) with 3-year survival data. Men were older (mean age 66·5 vs 63·6 years), more commonly received mechanical ventilation (27·4% vs 24·7%) and renal replacement therapy (8·2% vs 6·8%) and had worse survival (Hazard Ratio [HR] 1·11; 95% Confidence Interval [CI] 1·07 to 1·14, P<0·001) compared to women. The duration of hospital and ICU stay was longer for men, compared to women (median hospital stay, 9.8 vs 9.4 days; p<0.001 and ICU stay, 2.7 vs 2.6 days; p<0.001).
Men are more likely to be admitted to ICU with sepsis and have worse survival for up to 3-years. Understanding causal mechanisms of sex differences may facilitate the development of targeted sepsis strategies.</description><subject>Adult</subject><subject>Age groups</subject><subject>Aged</subject><subject>Analysis</subject><subject>Australia</subject><subject>Care and treatment</subject><subject>Chronic fatigue syndrome</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Demographic aspects</subject><subject>Female</subject><subject>Frailty</subject><subject>Gender differences</subject><subject>Health risks</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Infection</subject><subject>Infections</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medicine and Health 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differences in long-term survival after intensive care unit treatment for sepsis: A cohort study</title><author>Thompson, Kelly ; Hammond, Naomi ; Bailey, Michael ; Darvall, Jai ; Low, Gary ; McGloughlin, Steven ; Modra, Lucy ; Pilcher, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-6516a9833aa1fa9f1c8fba4184638026eb8bedd40d31606ef6c67ea75fe62bcc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Age groups</topic><topic>Aged</topic><topic>Analysis</topic><topic>Australia</topic><topic>Care and treatment</topic><topic>Chronic fatigue syndrome</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Demographic aspects</topic><topic>Female</topic><topic>Frailty</topic><topic>Gender differences</topic><topic>Health risks</topic><topic>Hospital 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Kelly</au><au>Hammond, Naomi</au><au>Bailey, Michael</au><au>Darvall, Jai</au><au>Low, Gary</au><au>McGloughlin, Steven</au><au>Modra, Lucy</au><au>Pilcher, David</au><au>Lazzeri, Chiara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex differences in long-term survival after intensive care unit treatment for sepsis: A cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-02-24</date><risdate>2023</risdate><volume>18</volume><issue>2</issue><spage>e0281939</spage><epage>e0281939</epage><pages>e0281939-e0281939</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To determine the effect of sex on sepsis-related ICU admission and survival for up to 3-years.
Retrospective cohort study of adults admitted to Australian ICUs between 2018 and 2020. Men and women with a primary diagnosis of sepsis were included. The primary outcome of time to death for up to 3-years was examined using Kaplan Meier plots. Secondary outcomes included the duration of ICU and hospital stay.
Of 523,576 admissions, there were 63,039 (12·0%) sepsis-related ICU admissions. Of these, there were 50,956 patients (43·4% women) with 3-year survival data. Men were older (mean age 66·5 vs 63·6 years), more commonly received mechanical ventilation (27·4% vs 24·7%) and renal replacement therapy (8·2% vs 6·8%) and had worse survival (Hazard Ratio [HR] 1·11; 95% Confidence Interval [CI] 1·07 to 1·14, P<0·001) compared to women. The duration of hospital and ICU stay was longer for men, compared to women (median hospital stay, 9.8 vs 9.4 days; p<0.001 and ICU stay, 2.7 vs 2.6 days; p<0.001).
Men are more likely to be admitted to ICU with sepsis and have worse survival for up to 3-years. Understanding causal mechanisms of sex differences may facilitate the development of targeted sepsis strategies.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36827250</pmid><doi>10.1371/journal.pone.0281939</doi><tpages>e0281939</tpages><orcidid>https://orcid.org/0000-0003-2304-8931</orcidid><orcidid>https://orcid.org/0000-0001-7364-8316</orcidid><orcidid>https://orcid.org/0000-0002-0062-3705</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adult Age groups Aged Analysis Australia Care and treatment Chronic fatigue syndrome Cohort analysis Cohort Studies Confidence intervals Demographic aspects Female Frailty Gender differences Health risks Hospital Mortality Humans Infection Infections Intensive care Intensive Care Units Length of Stay Male Mechanical ventilation Medicine and Health Sciences Men Mortality Patient admissions People and Places Physical Sciences Physiology Retrospective Studies Sepsis Severe acute respiratory syndrome coronavirus 2 Sex Characteristics Sex differences Socioeconomic factors Survival Ventilation Women Womens health |
title | Sex differences in long-term survival after intensive care unit treatment for sepsis: A cohort study |
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