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Title: Sex differences in illness severity and mortality among adult intensive care patients: A systematic review and meta-analysis.
Austin Authors: Modra, Lucy J ;Higgins, Alisa;Vithanage, Ruvini;Abeygunawardana, Vihangi;Bailey, Michael;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Monash Health, VIC, Australia
Centre for Integrated Critical Care, University of Melbourne, Melbourne, VIC, Australia
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia
Australia and New Zealand Intensive Care Research Centre, School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia
Intensive Care
Issue Date: Oct-2021
Date: 2021-06-04
Publication information: Journal of Critical Care 2021; 65: 116-123
Abstract: To investigate the association between sex and illness severity and mortality of ICU patients. We performed systematic searches of MEDLINE and EMBASE for observational studies of adult ICU patients that explicitly examined the association between sex and illness severity or mortality. We used a random effects model to calculate standardised mean differences in illness severity scores and pooled odds ratios for mortality of women compared to men. We identified 21 studies with 505,138 participants in total (43.1% women). There was substantial heterogeneity among studies. Only two studies were at low risk of bias overall. At ICU admission, there was a pattern of higher illness severity scores among women (standardised mean difference 0.04, 95% CI -0.01-0.09). Women had higher risk-adjusted mortality than men at ICU discharge (OR 1.25 95% CI 1.03-1.50) and 1 year (OR 1.08, 95% CI 1.02-1.13), however this finding was not robust to sensitivity analysis. Women tend to have higher illness severity scores at ICU admission. Women also appear to have higher risk-adjusted mortality than men at ICU discharge and at 1 year. Given the heterogeneity and risk of bias in the existing literature, additional studies are needed to confirm or refute these findings.
DOI: 10.1016/j.jcrc.2021.05.019
Journal: Journal of Critical Care
PubMed URL: 34118502
Type: Journal Article
Subjects: Gender
Illness severity
Intensive care
Appears in Collections:Journal articles

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