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Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Gender-related differences in intensive care: a multiple-center cohort study of therapeutic interventions and outcome
Andreas Valentin1, Barbara Jordan, Thomas Lang
1II Medical Department, KA Rudolfstiftung, Vienna, Austria. andreas.valentin@wienkav.at
Objective:
To determine whether gender-related differences exist in the provided level of care and outcome in a large cohort of critically ill patients.
Design:
Prospective, observational cohort study with data collection from January 1, 1998, to December 31, 2000.
Setting:
Thirty-one intensive care units in Austria.
Patients:
A total of 25,998 adult patients, consecutively admitted to 31 intensive care units in Austria.
Interventions:
We assessed severity of illness, level of provided care, and vital status at hospital discharge.
Measurements And Main Results:
Of 25,998 patients, 58.3% were male and 41.7% were female. Hospital mortality rate was slightly higher in women (18.1%) than in men (17.2%), but severity of illness-adjusted mortality rate was not different. Men received an overall increased level of care and had a significantly higher probability of receiving invasive procedures, such as mechanical ventilation (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.16-1.28), single vasoactive medication (OR, 1.18; 95% CI, 1.12-1.24), multiple vasoactive medication (OR, 1.21; 95% CI, 1.15-1.28), intravenous replacement of large fluid losses (OR, 1.14; 95% CI, 1.08-1.20), central venous catheter (OR, 1.06; 95% CI, 1.01-1.12), peripheral arterial catheter (OR, 1.15; 95% CI, 1.10-1.22), pulmonary artery catheter (OR, 1.48; 95% CI, 1.34-1.62), renal replacement therapy (OR, 1.28; 95% CI, 1.16-1.42), and intracranial pressure measurement (OR, 1.34; 95% CI, 1.18-1.53).
Conclusions:
In a large cohort of critically ill patients, no differences in severity of illness-adjusted mortality rate between men and women were found. Despite a higher severity of illness in women, men received an increased level of care and underwent more invasive procedures. This different therapeutic approach in men did not translate into a better outcome.
