Propensity-Score Analysis Reveals that Sex is Not a Prognostic Factor for Mortality in Intensive Care Unit-Admitted Patients with Septic Bacteremia

• Published in: International journal of infectious diseases Vol. 110; pp. 36 - 44
• Main Authors: Ponce-Alonso, Manuel, Fernández-Félix, Borja M., Halperin, Ana, Rodríguez-Domínguez, Mario, Sánchez-Díaz, Ana M., Cantón, Rafael, Muriel, Alfonso, Zamora, Javier, del Campo, Rosa
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.09.2021; Elsevier
• Subjects: Bacteremia - epidemiology; Female; Hospital Mortality; Humans; ICU; Intensive Care Units; Male; Mortality; Prognosis; Propensity Score; Retrospective Studies; Sepsis; Sex; Sepsis; ICU; Propensity score; Mortality; Sex
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2021.07.034

•Sepsis was more common in males than females•Males with sepsis presented higher disease severity than females•Sex did not affect mortality in patients with sepsis and admitted to intensive care units Men have been considered to have a higher incidence of infectious diseases, with controversy over the possibility that sex could influence the prognosis of the infection. This study aimed to explore this assumption in patients admitted to the intensive care unit (ICU) with septic bacteremia. A retrospective analysis (2006-2017) of septic patients with microbiologically confirmed bacteremia (n=440) was performed. Risk of ICU and in-hospital mortality in males versus females was compared by univariate analysis and a propensity score analysis integrating their clinical characteristics. Sepsis more frequently occurred in males (80.2% vs 76.1%) as well as in-hospital (48.0% vs 41.3%) and ICU (39.9% vs 36.5%) mortality. Univariate analyses showed that males had a higher Charlson comorbidity index and worse McCabe prognostic score. However, the propensity score in 296 matched patients demonstrated that females had higher risk of both ICU (OR 1.39; 95% CI 0.89-2.19) and in-hospital mortality (OR 1.18; 95% CI 0.77-1.83), but without statistical significance. Males with sepsis had worse clinical characteristics when admitted to the ICU, but sex had no influence on mortality. These data contribute to helping reduce the sex-dependent gap present in healthcare provision.