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Gender-based differences in children with sepsis and ARDS: the ESPNIC ARDS Database Group
Lutz Bindl1, Stephan Buderus, Peter Dahlem
1University Childrens Hospital, Adenauerallee 119, 53113 Bonn, Germany. bindl@mailer.ukb.uni-bonn.de
Intensive Care Medicine
|August 16, 2003
Summary
Male children are more prone to severe sepsis, even before puberty. This study found a higher male-to-female ratio in sepsis patients, suggesting factors beyond testosterone influence this gender disparity in severe sepsis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Male gender is a known risk factor for severe sepsis and septic shock, often attributed to higher testosterone levels.
- This predisposition is typically observed in adults, but its presence in prepubertal children, with low sex hormone levels, remained unclear.
Purpose of the Study:
- To investigate if a male preponderance exists in prepubertal patients with severe sepsis, similar to adults.
- To explore potential factors contributing to gender differences in sepsis severity in young children.
Main Methods:
- Retrospective analysis of the ESPNIC ARDS database for patients aged up to 8 years with sepsis.
- Comparison of male/female ratios in septic patients versus non-septic ARDS patients.
- Subgroup analysis based on age and causative bacteria (Neisseria meningitidis vs. others).
Main Results:
- A significant male preponderance (M/F ratio 1.7) was observed in prepubertal sepsis patients, comparable to adult sepsis data.
- The male preponderance was highest in infants (1-12 months) with a M/F ratio of 2.8.
- No male preponderance was found in patients with meningococcal septic shock, and the overall M/F ratio for severe sepsis (excluding meningococcal) was 2.1.
Conclusions:
- Prepubertal children with sepsis exhibit an increased frequency of males, similar to adult populations.
- The male preponderance in severe sepsis among young children is likely due to factors other than testosterone.
- Further research is needed to identify non-hormonal factors contributing to gender disparities in pediatric sepsis.