Children's Research Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
Syst Rev. 2024 Aug 8;13(1):214. doi: 10.1186/s13643-024-02631-z.
Pediatric sepsis remains a leading cause of childhood morbidity and mortality worldwide. Despite advancements in modern medicine, it accounts for more than 3 million childhood deaths per year. Multiple studies have emphasized that sex and gender have an impact on the treatment and outcome of various diseases. Adult studies have revealed sex differences in pathophysiological responses to septic shock, as well as a possible protective effect of estrogens on critical illness. Sex-specific maturational and developmental differences in host immunology have been previously demonstrated for neonatal and pediatric age groups. At present, there are no studies assessing the impact of sex on outcomes of children with sepsis.
The goal of this study is to assess sex-specific differences in childhood sepsis survival outcomes. We will systematically assess associations of sex and gender with outcomes in pediatric sepsis in the literature by performing a systematic search of MEDLINE and Embase databases. We will include all English language randomized trials and cohort studies. The study population will include children > 37 weeks gestational age and < 18 years of age. Exposure will be sepsis, severe sepsis, and septic shock and the main comparison will be between male and female sex. The primary outcome will be hospital mortality. Secondary outcomes will be the pediatric intensive care unit and hospital length of stay.
Results from this review are expected to provide important information on the association of sex with the outcomes of pediatric sepsis. If an association is noted, this study may serve as a foundation for further research evaluating the pathophysiological aspects as well as potential socioeconomic factors responsible for the clinically detected sex differences.
PROSPERO CRD42022315753.
儿科脓毒症仍然是全球儿童发病率和死亡率的主要原因。尽管现代医学取得了进步，但每年仍有超过 300 万儿童因此死亡。多项研究强调，性别对各种疾病的治疗和结果有影响。成人研究表明，脓毒性休克的病理生理反应存在性别差异，雌激素对危重病可能有保护作用。先前已经证明，新生儿和儿科年龄组的宿主免疫学存在性别特异性成熟和发育差异。目前，尚无研究评估性别对脓毒症儿童结局的影响。
本研究旨在评估儿童脓毒症生存结局的性别差异。我们将通过对 MEDLINE 和 Embase 数据库进行系统检索，评估文献中性别与儿科脓毒症结局的关联。我们将纳入所有英语随机试验和队列研究。研究人群将包括胎龄大于 37 周且年龄小于 18 岁的儿童。暴露因素为脓毒症、严重脓毒症和脓毒性休克，主要比较为男性和女性。主要结局为医院死亡率。次要结局为儿科重症监护病房和医院住院时间。
本综述的结果有望提供有关性别与儿科脓毒症结局关联的重要信息。如果注意到关联，这项研究可能为进一步评估潜在的病理生理和潜在的社会经济因素导致临床发现的性别差异的研究奠定基础。
PROSPERO CRD42022315753。
