Sex Differences in Mortality of ICU Patients According to Diagnosis-related Sex Balance

• Published in: American journal of respiratory and critical care medicine 2022-12, Vol.206 (11), p.1353-1360
• Main Authors: Modra, Lucy J, Higgins, Alisa M, Pilcher, David V, Bailey, Michael J, Bellomo, Rinaldo
• Format: Article
• Language: English
• Subjects: Adult; Australia - epidemiology; Epidemiology; Female; Gender differences; Hospital Mortality; Humans; Intensive care; Intensive Care Units; Male; Medical diagnosis; Mortality; Original; Regression analysis; Retrospective Studies; Sex Characteristics
• ISSN: 1073-449X; 1535-4970; 1535-4970
• DOI: 10.1164/rccm.202203-0539OC

Women have worse outcomes than men in several conditions more common in men, including cardiac surgery and burns. To describe the relationship between sex balance within each diagnostic group of ICU admissions, defined as the percentage of patients who were women, and hospital mortality of women compared with men with that same diagnosis. We studied ICU patients in the Australian and New Zealand Intensive Care Society's Adult Patient Database (2011-2020). We performed mixed effects logistic regression for hospital mortality adjusted for sex, illness severity, ICU lead time, admission year, and hospital site. We compared sex balance with the adjusted hospital mortality of women compared with men for each diagnosis using weighted linear regression. There were 1,450,782 admissions (42.1% women), with no difference in the adjusted hospital mortality of women compared with men overall (odds ratio, 0.99; 99% confidence interval [CI], 0.97 to 1). As the percentage of women within each diagnosis increased, the adjusted mortality of women compared with men with that same diagnosis decreased (regression coefficient, -0.015; 99% CI; -0.020 to -0.011;