Sex Differences in Sepsis-Related Acute Respiratory Distress Syndrome and Other Short-Term Outcomes among Critically Ill Patients with Sepsis: A Retrospective Study in China.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2025-02-04 DOI:10.1097/SHK.0000000000002555

Hui Zhao, Bin Yang, Hong-Kai Dai, Cheng Li, Hang Ruan, Yong-Sheng Li

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引用次数: 0

Abstract

Background: The evidence of sex disparity in acute respiratory distress syndrome (ARDS) is scarce and varies widely.

Objective: This observational, retrospective study aimed to determine the effect of sex on the sepsis-related ARDS and other short outcomes in critically ill patients with sepsis.

Methods: A total of 2111 adult patients with sepsis who were admitted to three central intensive care units (ICUs) of Wuhan Tongji Hospital between 2012 and 2022 were included in our analysis. Sex was considered as an exposure factor, with sepsis-related ARDS as the primary outcome, and in-hospital mortality, invasive mechanical ventilation(iMV) support, septic shock, and other complications as secondary outcomes.

Results: Among the 2111 enrolled patients, 1287 were males (61%) and 824 were females (39%). The incidence of sepsis-related ARDS was higher in males compared to females (P = 0.001), as well as in-hospital mortality (P = 0.009). Multivariate logistic analysis demonstrated that male sex remained independently associated with an increased risk of sepsis-related ARDS (adjusted odds ratio(aOR) = 1. 493[1.034-2.156], P = 0.032). Propensity score matching analysis also indicated that males had 58% higher odds of developing sepsis-related ARDS (aOR = 1.584 [1.022-2.456], P = 0.040). Regarding secondary outcomes, male sex was identified as a risk factor for in-hospital mortality (aOR = 1.536 [1.087-2.169], P = 0.015) and iMV support (aOR = 1.313 [1.029-1.674], P = 0.028) in the fully adjusted model. Sensitivity analysis that included postmenopausal females and age-matched male counterparts showed that male sex still remained to be a risk factor of developing sepsis-related ARDS (aOR = 1.968 [1.241-3.120], P = 0.004).

Conclusion: Male sex was identified as an independent risk factor for sepsis-related ARDS and in-hospital mortality among critically ill patients with sepsis. Given the retrospective design of this study, the relationship between sex and sepsis-related ARDS requires further validation through large-scale randomized controlled trials in the future.

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中国危重症脓毒症患者脓毒症相关急性呼吸窘迫综合征及其他短期预后的性别差异：一项回顾性研究

背景：急性呼吸窘迫综合征（ARDS）性别差异的证据很少且差异很大。目的：本观察性、回顾性研究旨在确定性别对脓毒症危重患者脓毒症相关ARDS及其他短期结局的影响。方法：选取2012 - 2022年武汉市同济医院3个中心重症监护室（icu）收治的成年脓毒症患者2111例进行分析。性别被认为是一个暴露因素，败血症相关的ARDS是主要结局，院内死亡率、有创机械通气（iMV）支持、感染性休克和其他并发症是次要结局。结果：2111例入组患者中，男性1287例（61%），女性824例（39%）。男性败血症相关ARDS的发生率高于女性（P = 0.001），住院死亡率也高于女性（P = 0.009）。多因素logistic分析显示，男性与败血症相关的ARDS风险增加仍然独立相关（校正优势比(aOR) = 1）。[1.034-2.156], p = 0.032)。倾向评分匹配分析还显示，男性发生败血症相关ARDS的几率比男性高58% （aOR = 1.584 [1.022-2.456], P = 0.040）。次要结局方面，在完全调整后的模型中，男性性别是住院死亡率（aOR = 1.536 [1.087-2.169], P = 0.015）和iMV支持（aOR = 1.313 [1.029-1.674], P = 0.028）的危险因素。包括绝经后女性和同龄男性的敏感性分析显示，男性仍然是发生败血症相关ARDS的危险因素（aOR = 1.968 [1.241-3.120], P = 0.004）。结论：男性是脓毒症重症患者脓毒症相关ARDS和院内死亡的独立危险因素。考虑到本研究的回顾性设计，性别与败血症相关ARDS之间的关系需要在未来通过大规模随机对照试验进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.