Sex, time, and disability status differences in mortality, multidimensional morbidity, and health care utilization: a...

We assessed the association of sex with ICU mortality and longitudinal Functional Independence Measure (FIM) scores, Beck Depression Inventory-II (BDI-II), Impact of Event Scale-Revised (IES-R), and healthcare utilization to 1-year after hospital discharge.

Secondary analysis of medical/surgical patients in the Canadian Towards RECOVER study.

Of 463 (185 females, 278 males) participants, significantly more males 45 (16.2%) versus females 20 (10.8%) died in the intensive care unit (ICU) [Hazard Ratio (HR) 1.8 (1.1, 3.1); p = 0.03]. Of 398 (165 females, 233 males) ICU survivors, 391 had FIM scores. Median FIM scores were significantly higher for male (versus female) survivors at 3-months (117 versus 106 points; p = 0.005), 6-months (119 versus 111.5 points; p = 0.005), and 12-months (121 versus 115 points; p = 0.003). Conversely, female (versus male) survivors had significantly higher BDI-II scores at 3-months [12.50 (7.0, 18.0) versus 9.0 (5.3, 14.8); p = 0.036], 6-months [11.8 (6.0, 17.8) versus 7.2 (3.0, 14.0); p = 0.009], 12-months [10.0 (4.0, 19.0) versus 11 (3.0, 26.3); p = 0.036] and higher IES-R scores at 3-months. Female survivors also experienced significantly more moderate (versus mild) [OR 6.9 (3.5, 13.7); p < 0.0001] and severe (versus moderate)[OR 40.9 (17.1, 98.2); p < 0.0001] depression. Whereas female ICU survivors had more rheumatology and nephrology specialty visits, males had more cardiology, endocrinology, surgical, and rehabilitation visits.

Although male ICU survivors experienced significantly higher ICU mortality, females experienced significantly lower longitudinal FIM scores and more frequent and severe depression.