Johansson Frigyesi E, Andersson P, Frigyesi A
Department of Paediatrics, Helsingborg Hospital, Helsingborg, Sweden.
Section for anaesthesiology and intensive care, Department of Clinical Sciences, Lund University, Lund, Sweden.
Acta Paediatr. 2017 Dec;106(12):1973-1978. doi: 10.1111/apa.14044. Epub 2017 Sep 17.
We investigated possible gender differences in paediatric intensive care morbidity-adjusted mortality.
In this study, data on all 21 972 paediatric intensive care admissions in Sweden between 2008 and 2015 were analysed regarding morbidity-adjusted survival, using Cox regression, with age, gender and estimated mortality ratio as dependent variables and using the standardised mortality ratio at 90 days after admission. The data were obtained from the Swedish Intensive Care Registry.
We found that boys had better overall survival than girls (hazard ratio 0.91 for boys, p = 0.035). In addition, the 90-day survival was also better for boys (standardised mortality ratio 0.85 for boys versus 1.02 for girls, p = 0.0014). The survival advantage was most evident in children less than a year old and for nonsurgical patients. The male advantage was also seen in children admitted with respiratory insufficiency and seizures and was furthermore independent of any concurrent cardiac condition. We did not find any gender difference in the intensity of care or length of stay when corrected for morbidity.
This study showed that boys have better outcomes than girls after intensive care admissions. The difference does not seem to be based on inequality of care.
我们调查了儿科重症监护中发病率调整后的死亡率可能存在的性别差异。
在本研究中，分析了瑞典2008年至2015年间所有21972例儿科重症监护入院病例的发病率调整后的生存数据，使用Cox回归分析，将年龄、性别和估计死亡率作为因变量，并采用入院后90天的标准化死亡率。数据来自瑞典重症监护登记处。
我们发现男孩的总体生存率高于女孩（男孩的风险比为0.91，p = 0.035）。此外，男孩的90天生存率也更高（男孩的标准化死亡率为0.85，女孩为1.02，p = 0.0014）。生存优势在1岁以下儿童和非手术患者中最为明显。在因呼吸功能不全和癫痫入院的儿童中也观察到男性优势，并且该优势独立于任何并发的心脏疾病。在校正发病率后，我们未发现护理强度或住院时间存在任何性别差异。
本研究表明，重症监护入院后男孩的预后比女孩更好。这种差异似乎并非基于护理不平等。
