Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34690
Title: Epidemiology of intensive care patients classified as a third sex in Australia and New Zealand.
Austin Authors: Modra, Lucy J ;Higgins, Alisa M;Pilcher, David V;Cheung, Ada S ;Carpenter, Morgan N;Bailey, Michael;Zwickl, Sav;Bellomo, Rinaldo 
Affiliation: Intensive Care
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne Australia; Intensive Care Unit, Alfred Health, Melbourne, Australia; The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Camberwell Road, Camberwell, Melbourne, Australia.
Trans Health Research Group, Department of Medicine, The University of Melbourne, Australia.
The University of Sydney School of Public Health.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne Australia.
Trans Health Research Group, Department of Medicine, The University of Melbourne, Australia.
Department of Critical Care, University of Melbourne, Melbourne, Australia; Intensive Care Unit, Austin Health, Melbourne, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne Australia; Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Australia.
Issue Date: 9-Dec-2023
Date: 2023
Publication information: Chest 2023-12-09
Abstract: Patient sex affects treatment and outcomes in critical illness. Previous studies of sex differences in critical illness compared female and male patients. In this study we describe the group of patients classified as a third sex admitted to intensive care units (ICUs) in Australia and New Zealand. What are the admission characteristics and outcomes of ICU patients classified as belonging to a third sex group, compared to patients classified female or male? Retrospective observational study of admissions to 200 ICUs, recorded in the Australia and New Zealand Intensive Care Society's Adult Patient Database 2018-2022. We undertook mixed effect logistic regression to compare hospital mortality across the sex groups, adjusted for illness severity, diagnosis, treatment limitation, year and hospital. We examined 892,161 admissions, of whom 525 (0.06%) were classified as third sex. Patients classified as third sex were represented across all diagnostic categories, jurisdictions, and hospital types. On average, they were younger than the groups classified as female (59.2+/-20.0 years vs 61.3+/-18.4 years, p=0.02) or male (63.2+/-16.7 years, p<0.001). Patients classified as third sex were more likely to be admitted following orthopedic surgery (10.1% third sex admissions (95% CI 7.7-13.0%) vs 6.2% female (95% CI 6.1-6.3%); 4.8% male (95% CI 4.7-4.9%)) and drug overdose (8.8% third sex admissions (95% CI 6.5-11.5%) vs 4.2% female (95% CI 4.1-4.2%); 3.1% male (95% CI 3.0-3.1%)). There was no difference in the adjusted hospital mortality of patients classified as third sex compared to the other groups. Patients classified as third sex composed a small minority of adult ICU patients. This group had a different diagnostic casemix, but similar outcomes, to the groups classified as female or male. Further characterizing a third sex group will require improved processes for recording sex and gender in health records.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34690
DOI: 10.1016/j.chest.2023.11.043
ORCID: 
Journal: Chest
PubMed URL: 38081578
ISSN: 1931-3543
Type: Journal Article
Subjects: critical illness
gender
intensive care unit
sex
Appears in Collections:Journal articles

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