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Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis
Female and male very elderly intensive patients (VIPs) might differ in characteristics and outcomes. We aimed to compare female versus male VIPs in a large, multinational collective of VIPs with regards to outcome and predictors of mortality. In total, 7555 patients were included in this analysis, 3...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7596065/ https://www.ncbi.nlm.nih.gov/pubmed/33122713 http://dx.doi.org/10.1038/s41598-020-74910-3 |
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author | Wernly, Bernhard Bruno, Raphael Romano Kelm, Malte Boumendil, Ariane Morandi, Alessandro Andersen, Finn H. Artigas, Antonio Finazzi, Stefano Cecconi, Maurizio Christensen, Steffen Faraldi, Loredana Lichtenauer, Michael Muessig, Johanna M. Marsh, Brian Moreno, Rui Oeyen, Sandra Öhman, Christina Agvald Pinto, Bernado Bollen Soliman, Ivo W. Szczeklik, Wojciech Niederseer, David Valentin, Andreas Watson, Ximena Leaver, Susannah Boulanger, Carole Walther, Sten Schefold, Joerg C. Joannidis, Michael Nalapko, Yuriy Elhadi, Muhammed Fjølner, Jesper Zafeiridis, Tilemachos De Lange, Dylan W. Guidet, Bertrand Flaatten, Hans Jung, Christian |
author_facet | Wernly, Bernhard Bruno, Raphael Romano Kelm, Malte Boumendil, Ariane Morandi, Alessandro Andersen, Finn H. Artigas, Antonio Finazzi, Stefano Cecconi, Maurizio Christensen, Steffen Faraldi, Loredana Lichtenauer, Michael Muessig, Johanna M. Marsh, Brian Moreno, Rui Oeyen, Sandra Öhman, Christina Agvald Pinto, Bernado Bollen Soliman, Ivo W. Szczeklik, Wojciech Niederseer, David Valentin, Andreas Watson, Ximena Leaver, Susannah Boulanger, Carole Walther, Sten Schefold, Joerg C. Joannidis, Michael Nalapko, Yuriy Elhadi, Muhammed Fjølner, Jesper Zafeiridis, Tilemachos De Lange, Dylan W. Guidet, Bertrand Flaatten, Hans Jung, Christian |
author_sort | Wernly, Bernhard |
collection | PubMed |
description | Female and male very elderly intensive patients (VIPs) might differ in characteristics and outcomes. We aimed to compare female versus male VIPs in a large, multinational collective of VIPs with regards to outcome and predictors of mortality. In total, 7555 patients were included in this analysis, 3973 (53%) male and 3582 (47%) female patients. The primary endpoint was 30-day-mortality. Baseline characteristics, data on management and geriatric scores including frailty assessed by Clinical Frailty Scale (CFS) were documented. Two propensity scores (for being male) were obtained for consecutive matching, score 1 for baseline characteristics and score 2 for baseline characteristics and ICU management. Male VIPs were younger (83 ± 5 vs. 84 ± 5; p < 0.001), less often frail (CFS > 4; 38% versus 49%; p < 0.001) but evidenced higher SOFA (7 ± 6 versus 6 ± 6 points; p < 0.001) scores. After propensity score matching, no differences in baseline characteristics could be observed. In the paired analysis, the mortality in male VIPs was higher (mean difference 3.34% 95%CI 0.92–5.76%; p = 0.007) compared to females. In both multivariable logistic regression models correcting for propensity score 1 (aOR 1.15 95%CI 1.03–1.27; p = 0.007) and propensity score 2 (aOR 1.15 95%CI 1.04–1.27; p = 0.007) male sex was independently associated with higher odds for 30-day-mortality. Of note, male gender was not associated with ICU mortality (OR 1.08 95%CI 0.98–1.19; p = 0.14). Outcomes of elderly intensive care patients evidenced independent sex differences. Male sex was associated with adverse 30-day-mortality but not ICU-mortality. Further research to identify potential sex-specific risk factors after ICU discharge is warranted. Trial registration: NCT03134807 and NCT03370692; Registered on May 1, 2017 https://clinicaltrials.gov/ct2/show/NCT03370692. |
format | Online Article Text |
id | pubmed-7596065 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-75960652020-10-30 Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis Wernly, Bernhard Bruno, Raphael Romano Kelm, Malte Boumendil, Ariane Morandi, Alessandro Andersen, Finn H. Artigas, Antonio Finazzi, Stefano Cecconi, Maurizio Christensen, Steffen Faraldi, Loredana Lichtenauer, Michael Muessig, Johanna M. Marsh, Brian Moreno, Rui Oeyen, Sandra Öhman, Christina Agvald Pinto, Bernado Bollen Soliman, Ivo W. Szczeklik, Wojciech Niederseer, David Valentin, Andreas Watson, Ximena Leaver, Susannah Boulanger, Carole Walther, Sten Schefold, Joerg C. Joannidis, Michael Nalapko, Yuriy Elhadi, Muhammed Fjølner, Jesper Zafeiridis, Tilemachos De Lange, Dylan W. Guidet, Bertrand Flaatten, Hans Jung, Christian Sci Rep Article Female and male very elderly intensive patients (VIPs) might differ in characteristics and outcomes. We aimed to compare female versus male VIPs in a large, multinational collective of VIPs with regards to outcome and predictors of mortality. In total, 7555 patients were included in this analysis, 3973 (53%) male and 3582 (47%) female patients. The primary endpoint was 30-day-mortality. Baseline characteristics, data on management and geriatric scores including frailty assessed by Clinical Frailty Scale (CFS) were documented. Two propensity scores (for being male) were obtained for consecutive matching, score 1 for baseline characteristics and score 2 for baseline characteristics and ICU management. Male VIPs were younger (83 ± 5 vs. 84 ± 5; p < 0.001), less often frail (CFS > 4; 38% versus 49%; p < 0.001) but evidenced higher SOFA (7 ± 6 versus 6 ± 6 points; p < 0.001) scores. After propensity score matching, no differences in baseline characteristics could be observed. In the paired analysis, the mortality in male VIPs was higher (mean difference 3.34% 95%CI 0.92–5.76%; p = 0.007) compared to females. In both multivariable logistic regression models correcting for propensity score 1 (aOR 1.15 95%CI 1.03–1.27; p = 0.007) and propensity score 2 (aOR 1.15 95%CI 1.04–1.27; p = 0.007) male sex was independently associated with higher odds for 30-day-mortality. Of note, male gender was not associated with ICU mortality (OR 1.08 95%CI 0.98–1.19; p = 0.14). Outcomes of elderly intensive care patients evidenced independent sex differences. Male sex was associated with adverse 30-day-mortality but not ICU-mortality. Further research to identify potential sex-specific risk factors after ICU discharge is warranted. Trial registration: NCT03134807 and NCT03370692; Registered on May 1, 2017 https://clinicaltrials.gov/ct2/show/NCT03370692. Nature Publishing Group UK 2020-10-29 /pmc/articles/PMC7596065/ /pubmed/33122713 http://dx.doi.org/10.1038/s41598-020-74910-3 Text en © The Author(s) 2020, corrected publication 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Wernly, Bernhard Bruno, Raphael Romano Kelm, Malte Boumendil, Ariane Morandi, Alessandro Andersen, Finn H. Artigas, Antonio Finazzi, Stefano Cecconi, Maurizio Christensen, Steffen Faraldi, Loredana Lichtenauer, Michael Muessig, Johanna M. Marsh, Brian Moreno, Rui Oeyen, Sandra Öhman, Christina Agvald Pinto, Bernado Bollen Soliman, Ivo W. Szczeklik, Wojciech Niederseer, David Valentin, Andreas Watson, Ximena Leaver, Susannah Boulanger, Carole Walther, Sten Schefold, Joerg C. Joannidis, Michael Nalapko, Yuriy Elhadi, Muhammed Fjølner, Jesper Zafeiridis, Tilemachos De Lange, Dylan W. Guidet, Bertrand Flaatten, Hans Jung, Christian Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis |
title | Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis |
title_full | Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis |
title_fullStr | Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis |
title_full_unstemmed | Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis |
title_short | Sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis |
title_sort | sex-specific outcome disparities in very old patients admitted to intensive care medicine: a propensity matched analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7596065/ https://www.ncbi.nlm.nih.gov/pubmed/33122713 http://dx.doi.org/10.1038/s41598-020-74910-3 |
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