Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Umeå University, Umeå, Sweden.
Ups J Med Sci. 2012 Nov;117(4):415-25. doi: 10.3109/03009734.2012.703255. Epub 2012 Jul 16.
Controversy exists regarding the influence of gender on sepsis events and outcome. Epidemiological data from other countries may not always apply to local circumstances. The aim of this study was to identify gender differences in patient characteristics, treatment, and outcome related to the occurrence of sepsis at admission to the ICU.
A prospective observational cohort study on patients admitted to the ICU over a 3-year period fulfilling sepsis criteria during the first 24 hours. Demographic data, APACHE II score, SOFA score, TISS 76, aetiology, length of stay (LOS), mortality rate, and aspects of treatment were collected and then analysed with respect to gender differences.
There were no gender-related differences in mortality or length of stay. Early organ dysfunction assessed as SOFA score at admission was a stronger risk factor for hospital mortality for women than for men. This discrepancy was mainly associated with the coagulation sub-score. CRP levels differed between genders in relation to hospital mortality. Infection from the abdominopelvic region was more common among women, whereas infection from skin or skin structures were more common in men.
In this cohort, gender was not associated with increased mortality during a 2-year follow-up period. SOFA score at ICU admission was a stronger risk factor for hospital mortality for women than for men. The discrepancy was mainly related to the coagulation SOFA sub-score. Together with differences in CRP levels this may suggest differences in inflammatory response patterns between genders.
性别对脓毒症事件和结局的影响存在争议。来自其他国家的流行病学数据并不总是适用于当地情况。本研究旨在确定 ICU 入院时发生脓毒症的患者特征、治疗和结局方面的性别差异。
对在 3 年内入住 ICU 的患者进行前瞻性观察性队列研究，在入住 ICU 的前 24 小时内符合脓毒症标准。收集人口统计学数据、APACHE II 评分、SOFA 评分、TISS 76、病因、住院时间 (LOS)、死亡率和治疗方面的数据，然后分析性别差异。
性别与死亡率或住院时间无关。入院时 SOFA 评分评估的早期器官功能障碍是女性住院死亡率的一个更强的危险因素，而不是男性。这种差异主要与凝血子评分有关。CRP 水平与性别相关，与住院死亡率有关。女性更常见的感染部位是腹盆腔，而男性更常见的感染部位是皮肤或皮肤结构。
在本队列中，性别与 2 年随访期间的死亡率增加无关。SOFA 评分是女性住院死亡率的一个更强的危险因素，而不是男性。差异主要与凝血 SOFA 子评分有关。与 CRP 水平的差异一起，这可能表明性别之间的炎症反应模式存在差异。
