Almossawi Ofran, Friend Amanda, Palla Luigi, Feltbower Richard, De Stavola Bianca
Department of Population, Policy and Practice, UCL GOS Institute of Child Health, London, UK
Department of Paediatrics, Leeds Children's Hospital, Leeds, UK.
BMJ Open. 2021 Feb 5;11(2):e046794. doi: 10.1136/bmjopen-2020-046794.
In the general population, female children have been reported to have a survival advantage. For children admitted to paediatric intensive care units (PICUs), mortality has been reported to be lower in males despite the higher admission rates for males into intensive care. This apparent sex reversal in PICU mortality is not well studied. To address this, we propose to conduct a systematic literature review to summarise the available evidence. Our review will study the reported differences in mortality between males and females aged 0-17, who died in a PICU, to examine if there is a difference between the two sexes in PICU mortality, and if so, to describe the magnitude and direction of this difference.
Studies that directly or indirectly addressed the association between sex and mortality in children admitted to intensive care will be eligible for inclusion. Studies that directly address the association will be eligible for data extraction. The search strings were based on terms related to the population (children in intensive care), the exposure (sex) and the outcome (mortality). We used the databases MEDLINE (1946-2020), Embase (1980-2020) and Web of Science (1985-2020) as these cover relevant clinical publications. We will assess the reliability of included studies using the risk of bias in observational studies of exposures tool. We will consider a pooled effect if we have at least three studies with similar periods of follow up and adjustment variables.
Ethical approval is not required for this review as it will synthesise data from existing studies. This manuscript is a part of a larger data linkage study, for which Ethical approval was granted. Dissemination will be via peer-reviewed journals and via public and patient groups.
CRD42020203009.
据报道，在普通人群中，女童具有生存优势。对于入住儿科重症监护病房（PICU）的儿童，尽管男性入住重症监护病房的比例较高，但据报道男性的死亡率较低。PICU死亡率中这种明显的性别逆转现象尚未得到充分研究。为解决这一问题，我们建议进行一项系统的文献综述，以总结现有证据。我们的综述将研究0至17岁在PICU死亡的男性和女性之间报告的死亡率差异，以检查PICU死亡率在两性之间是否存在差异，如果存在差异，则描述这种差异的大小和方向。
直接或间接涉及重症监护病房儿童性别与死亡率之间关联的研究将符合纳入条件。直接涉及该关联的研究将符合数据提取条件。检索词基于与人群（重症监护病房儿童）、暴露因素（性别）和结局（死亡率）相关的术语。我们使用了MEDLINE（1946 - 2020年）、Embase（1980 - 2020年）和Web of Science（1985 - 2020年）数据库，因为这些数据库涵盖了相关的临床出版物。我们将使用暴露因素观察性研究中的偏倚风险工具评估纳入研究的可靠性。如果我们至少有三项随访期和调整变量相似的研究，我们将考虑合并效应。
由于本综述将综合现有研究的数据，因此无需伦理批准。本手稿是一项更大的数据关联研究的一部分，该研究已获得伦理批准。传播将通过同行评审期刊以及公共和患者群体进行。
PROSPERO注册号：CRD42020203009。
