Association of Gender With Outcome and Host Response in Critically Ill Sepsis Patients.

Abstract:

OBJECTIVE:To determine the association of gender with the presentation, outcome, and host response in critically ill patients with sepsis. DESIGN AND SETTING:A prospective observational cohort study in the ICU of two tertiary hospitals between January 2011 and January 2014. PATIENTS:All consecutive critically ill patients admitted with sepsis, involving 1,815 admissions (1,533 patients). INTERVENTIONS:The host response was evaluated on ICU admission by measuring 19 plasma biomarkers reflecting organ systems implicated in sepsis pathogenesis (1,205 admissions) and by applying genome-wide blood gene expression profiling (582 admissions). MEASUREMENTS AND MAIN RESULTS:Sepsis patients admitted to the ICU were more frequently males (61.0%; p < 0.0001 vs females). Baseline characteristics were not different between genders. Urosepsis was more common in females; endocarditis and mediastinitis in men. Disease severity was similar throughout ICU stay. Mortality was similar up to 1 year after ICU admission, and gender was not associated with 90-day mortality in multivariate analyses in a variety of subgroups. Although plasma proteome analyses (including systemic inflammatory and cytokine responses, and activation of coagulation) were largely similar between genders, females showed enhanced endothelial cell activation; this difference was virtually absent in patients more than 55 years old. More than 80% of the leukocyte blood gene expression response was similar in male and female patients. CONCLUSIONS:The host response and outcome in male and female sepsis patients requiring ICU admission are largely similar.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

van Vught LA,Scicluna BP,Wiewel MA,Hoogendijk AJ,Klein Klouwenberg PMC,Ong DSY,Cremer OL,Horn J,Franitza M,Toliat MR,Nürnberg P,Bonten MMJ,Schultz MJ,van der Poll T,MARS Consortium.

doi

10.1097/CCM.0000000000002649

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

1854-1862

issue

11

eissn

0090-3493

issn

1530-0293

journal_volume

45

pub_type

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