Gender differences in mortality and quality of life after septic shock: A post-hoc analysis of the ARISE study

To assess the impact of gender and pre-menopausal state on short- and long-term outcomes in patients with septic shock. Cohort study of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial, an international randomized controlled trial comparing early goal-directed therapy (EGDT) to usua...

Full description

Saved in:
Bibliographic Details
Published in:Journal of critical care 2020-02, Vol.55, p.177-183
Main Authors: Luethi, Nora, Bailey, Michael, Higgins, Alisa, Howe, Belinda, Peake, Sandra, Delaney, Anthony, Bellomo, Rinaldo
Format: Article
Language:English
Subjects:
Adult
Age
Age groups
Aged
Blood pressure
Cardiac arrhythmia
Clinical outcomes
Comorbidity
Critical care
Early Goal-Directed Therapy
Female
Females
Gender difference
Gender differences
Hemoglobin
Humans
Illnesses
Intensive care
Kaplan-Meier Estimate
Male
Middle Aged
Mortality
Odds Ratio
Outcomes
Patients
Pre-menopausal state
Premenopause
Proportional Hazards Models
Prospective Studies
Quality of Life
Renal replacement therapy
Resuscitation - mortality
Sepsis
Septic shock
Sex
Sex Factors
Shock, Septic - mortality
Shock, Septic - psychology
Treatment Outcome
Ventilators
Womens health
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To assess the impact of gender and pre-menopausal state on short- and long-term outcomes in patients with septic shock. Cohort study of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial, an international randomized controlled trial comparing early goal-directed therapy (EGDT) to usual care in patients with early septic shock, conducted between October 2008 and April 2014. The primary exposure in this analysis was legal gender and the secondary exposure was pre-menopausal state defined by chronological age (≤ 50 years). 641 (40.3%) of all 1591 ARISE trial participants in the intention-to-treat population were females and overall, 337 (21.2%) (146 females) patients were 50  years of age or younger. After risk-adjustment, we could not identify any survival benefit for female patients at day 90 in the younger (≤50 years) (adjusted Odds Ratio (aOR): 0.91 (0.46–1.89), p = .85) nor in the older (>50 years) age-group (aOR: 1.10 (0.81–1.49), p = .56). Similarly, there was no gender-difference in ICU, hospital, 1-year mortality nor quality of life measures. This post-hoc analysis of a large multi-center trial in early septic shock has shown no short- or long-term survival effect for women overall as well as in the pre-menopausal age-group. •There is a male dominance among patients with severe sepsis and septic shock•We observed no difference in short- and long-term mortality nor quality of life measures after septic shock between male and female patients•In sepsis randomized controlled trials, the percentage of female patients does not affect findings
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2019.11.002