Literature DB >> 23706357

Impact of gender on sepsis mortality and severity of illness for prepubertal and postpubertal children.

Anoopindar K Ghuman1, Christopher J L Newth, Robinder G Khemani.   

Abstract

OBJECTIVE: To investigate differences in sepsis mortality between prepubertal and postpubertal males and females. STUDY
DESIGN: This was a retrospective review of the Virtual PICU Systems (VPS) database (including 74 pediatric intensive care units [PICUs]) for 2006-2008. We included prepubertal (aged 2-7 years) and postpubertal (aged 16-21 years) children with a primary diagnosis of sepsis admitted to a participating PICU.
RESULTS: Prepubertal females (n = 272; 9.9% mortality) and prepubertal males (n = 303; 10.9% mortality) had similar mortality and severity of illness (Pediatric Index of Mortality 2 risk of mortality [PIM 2 ROM]). Postpubertal females (n = 233; mortality, 5.6%) had lower mortality than postpubertal males (n = 212; mortality, 11.8%; P = .03). PIM 2 ROM was higher for postpubertal males than postpubertal females (P = .02). After controlling for hospital specific effects with multivariate modeling, in postpubertal children, female gender was independently associated with a lower initial severity of illness (PIM 2 ROM: OR, 0.77; 95% CI, 0.62-0.96; P = .02).
CONCLUSION: Sepsis mortality is similar in prepubertal males and females. However, postpubertal males have a higher sepsis mortality than postpubertal females, likely related to their greater severity of illness on PICU admission. These outcome differences in postpubertal children may reflect a hormonal influence on the response to infection or differences in underlying comorbidities, source of infection, or behavior.
Copyright © 2013 Mosby, Inc. All rights reserved.

Entities:  

Keywords:  AIC; Akaike information criterion; BIC; CARS; Compensatory anti-inflammatory response syndrome; LOS; Length of stay; PICU; PIM 2; Pediatric Index of Mortality 2; Pediatric intensive care unit; ROM; Risk of mortality; SIRS; Schwarz Bayes information criterion; Systemic inflammatory response syndrome; VPS; Virtual PICU Systems; ll; −2 log likelihood

Mesh:

Year:  2013        PMID: 23706357     DOI: 10.1016/j.jpeds.2013.04.018

Source DB:  PubMed          Journal:  J Pediatr        ISSN: 0022-3476            Impact factor:   4.406


  10 in total

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  10 in total

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