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Sex specific differences in short-term mortality after ICU-delirium
Nikolaus Schreiber1, Michael Eichlseder2, Simon Orlob1,3
1Divison of Heart-, Thoracic- and Vascular Anaesthesiology and Intensive Care Medicine, Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
Critical Care (London, England)
|December 19, 2024
Summary
Women experiencing intensive care unit (ICU) delirium face a higher risk of short-term mortality compared to men. This study highlights a significant sex-based disparity in ICU delirium outcomes, warranting further investigation.
Area of Science:
- Critical Care Medicine
- Neuroscience
- Epidemiology
Background:
- Delirium is a common complication in critically ill patients, linked to poor outcomes like cognitive impairment and mortality.
- Existing research has not clarified potential sex-based differences in intensive care unit (ICU) delirium and its associated risks.
- This study addresses the knowledge gap regarding sex-specific outcomes in ICU delirium.
Purpose of the Study:
- To investigate sex-specific differences in short-term mortality among adult patients diagnosed with delirium in the ICU.
- To determine if female sex is associated with increased mortality risk following the onset of ICU delirium.
Main Methods:
- A retrospective cohort study utilizing the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database.
- Included adult ICU patients diagnosed with delirium using the Confusion Assessment Method for the ICU (CAM-ICU).
- Employed 1:1 propensity score matching and Cox proportional hazards regression to analyze 30-day mortality, controlling for baseline characteristics.
Main Results:
- The study analyzed 8950 ICU patients with delirium (42.6% women).
- Women exhibited higher crude 30-day mortality (26.0% vs. 23.4%).
- After propensity score matching, women continued to show a significantly higher risk of 30-day mortality (HR 1.16, 95% CI 1.064-1.273).
Conclusions:
- Women with ICU delirium demonstrate a significantly elevated risk of short-term mortality compared to men.
- The findings suggest a sex-based disparity in ICU delirium outcomes.
- Further research is recommended to elucidate underlying biological and clinical factors and develop sex-specific interventions.
