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Comparing the Survival Analysis of Two or More Groups01:20

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Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
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Sex Differences in Pediatric Sepsis Mortality: A Systematic Review and Meta-Analysis.

Uchenna K Kennedy1, Juliette Moulin2, Lea Bührer3

  • 1Children's Research Center, Division of Pediatric Urology, Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland.

Critical Care Explorations
|March 31, 2025
PubMed
Summary

Pediatric sepsis mortality is higher in boys than girls, according to a large systematic review. This finding highlights potential sex-based disparities in childhood sepsis outcomes, warranting further investigation.

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Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Epidemiology

Background:

  • Pediatric sepsis is a significant global cause of childhood mortality.
  • Sex differences are known to influence disease risk, treatment, and outcomes.
  • Adult studies indicate sex-specific responses to septic shock.

Purpose of the Study:

  • To systematically review and meta-analyze the association between sex and outcomes in hospitalized children with sepsis.
  • To investigate potential sex-based differences in pediatric sepsis mortality.

Main Methods:

  • Searched Medline and Embase databases for studies published between January 2005 and March 2022.
  • Included cohort studies and randomized controlled trials involving children (≥37-week-old postconception to 18 years) with sepsis, severe sepsis, or septic shock.
  • Performed random-effects meta-analysis on extracted data, including patient demographics and illness severity.

Main Results:

  • Analyzed 124 studies involving 426,163 pediatric patients (47% girls).
  • Found moderate evidence of higher mortality in boys compared to girls with sepsis (Risk Difference: -0.005).
  • The association between higher boy mortality and sepsis persisted when adjusting for country income level.

Conclusions:

  • This systematic review and meta-analysis provides moderate evidence for increased sepsis mortality in boys compared to girls.
  • The observed sex difference in pediatric sepsis mortality is robust and remains significant even after accounting for national income levels.