Acute respiratory failure: a gender-based outcomes analysis.

OBJECTIVE

To determine the influence of gender on patient outcomes and the delivery of medical care during mechanical ventilation for acute respiratory failure.

DESIGN

A prospective cohort study.

SETTING

Medical intensive care unit of a university-affiliated urban teaching hospital.

PATIENTS

Three hundred twenty-one patients with acute respiratory failure requiring mechanical ventilation.

INTERVENTIONS

Prospective patient surveillance and data collection.

MEASUREMENTS AND RESULTS

One hundred six patients (33.0%) died during hospitalization. No statistically significant difference in mortality rates was observed between male and female patients (36.1% versus 30.1%; P = .252). The duration of mechanical ventilation, intensive care unit length of stay, and hospital length of stay were also similar between men and women with acute respiratory failure. The presence of the acute respiratory distress syndrome (ARDS; adjusted odds ratio [AOR] = 3.65; 95% confidence interval [CI] = 2.34 to 5.71; P = .004), the number of acquired organ system derangements (AOR = 1.36; 95% CI = 1.20 to 1.53; P = .013), the predicted hospital mortality using acute physiology and chronic health evaluation (APACHE) II scores (AOR = 1.05; 95% CI = 1.04 to 1.05; P < .001), and patient age (AOR = 1.02; 95% CI = 1.01 to 1.03; P = .016) were found to be independent determinants of hospital mortality using multiple logistic regression analysis.

CONCLUSIONS

These data suggest that important gender-specific differences in outcome do not occur among patients with respiratory failure requiring mechanical ventilation. Severity of illness, patient age, and acquired organ system derangements appear to be the most important determinants of mortality for patients with acute respiratory failure, regardless of patient gender.