We have located links that may give you full text access.
Journal Article
Research Support, Non-U.S. Gov't
The impact of gender on outcome from mechanical ventilation.
Chest 1997 Februrary
OBJECTIVE: To determine the relation of gender to outcome for patients requiring mechanical ventilation.
DESIGN: A prospective cohort study.
SETTING: Medical and surgical ICUs in two university-affiliated teaching hospitals.
PATIENTS: Three hundred fifty-seven patients requiring mechanical ventilation.
INTERVENTIONS: Prospective patient surveillance and data collection.
MEASUREMENTS AND RESULTS: The primary outcome measure was hospital mortality. Secondary outcome measures included need for reintubation, hospital and ICU length of stay, duration of mechanical ventilation, and hospital charges. The hospital mortality rate for women (n = 189) was significantly greater than the hospital mortality rate for men (n = 168) (28.0% vs 17.3%; p = 0.016). This difference in hospital mortality was observed despite similar baseline demographic characteristics, severity of illness, indications for mechanical ventilation, and number of dysfunctional organ systems in these two groups of patients. The duration of mechanical ventilation and ICU length of stay was also significantly longer for female patients compared with male patients (p < or = 0.056). In a logistic-regression analysis, female gender was found to be independently associated with hospital mortality (adjusted odds ratio [AOR] = 2.38; 95% confidence interval [CI] = 1.70 to 3.35; p = 0.010). The presence of ARDS (AOR = 10.69; 95% CI = 5.86 to 19.51; p < 0.001), the number of dysfunctional organ systems (AOR = 2.07; 95% CI = 1.78 to 2.41; p < 0.001), Acute Physiology and Chronic Health Evaluation (APACHE) II predicted mortality (AOR = 1.15; 95% CI = 1.11 to 1.19; p < 0.001), and patient age (AOR = 1.04; 95% CI = 1.03 to 1.06; p < 0.001) were also found to be independently associated with hospital mortality. The number of dysfunctional organ systems present at the start of mechanical ventilation was the major independent predictor of hospital mortality (54% of total explanatory power). Patient gender was the least important independent predictor of hospital mortality (5% of total explanatory power).
CONCLUSIONS: In this patient cohort, women requiring mechanical ventilation were at greater risk for hospital mortality than men. Physicians should be aware that outcome differences according to gender can occur when evaluating or designing clinical trials involving mechanically ventilated patients. Future studies are necessary to determine the general applicability of these findings and to identify explanations for such observed gender-specific differences in outcome.
DESIGN: A prospective cohort study.
SETTING: Medical and surgical ICUs in two university-affiliated teaching hospitals.
PATIENTS: Three hundred fifty-seven patients requiring mechanical ventilation.
INTERVENTIONS: Prospective patient surveillance and data collection.
MEASUREMENTS AND RESULTS: The primary outcome measure was hospital mortality. Secondary outcome measures included need for reintubation, hospital and ICU length of stay, duration of mechanical ventilation, and hospital charges. The hospital mortality rate for women (n = 189) was significantly greater than the hospital mortality rate for men (n = 168) (28.0% vs 17.3%; p = 0.016). This difference in hospital mortality was observed despite similar baseline demographic characteristics, severity of illness, indications for mechanical ventilation, and number of dysfunctional organ systems in these two groups of patients. The duration of mechanical ventilation and ICU length of stay was also significantly longer for female patients compared with male patients (p < or = 0.056). In a logistic-regression analysis, female gender was found to be independently associated with hospital mortality (adjusted odds ratio [AOR] = 2.38; 95% confidence interval [CI] = 1.70 to 3.35; p = 0.010). The presence of ARDS (AOR = 10.69; 95% CI = 5.86 to 19.51; p < 0.001), the number of dysfunctional organ systems (AOR = 2.07; 95% CI = 1.78 to 2.41; p < 0.001), Acute Physiology and Chronic Health Evaluation (APACHE) II predicted mortality (AOR = 1.15; 95% CI = 1.11 to 1.19; p < 0.001), and patient age (AOR = 1.04; 95% CI = 1.03 to 1.06; p < 0.001) were also found to be independently associated with hospital mortality. The number of dysfunctional organ systems present at the start of mechanical ventilation was the major independent predictor of hospital mortality (54% of total explanatory power). Patient gender was the least important independent predictor of hospital mortality (5% of total explanatory power).
CONCLUSIONS: In this patient cohort, women requiring mechanical ventilation were at greater risk for hospital mortality than men. Physicians should be aware that outcome differences according to gender can occur when evaluating or designing clinical trials involving mechanically ventilated patients. Future studies are necessary to determine the general applicability of these findings and to identify explanations for such observed gender-specific differences in outcome.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app