Jed Lipes1, Louay Mardini, Dev Jayaraman. 1. Department of Adult Critical Care, Jewish General Hospital, McGill University, Montreal, Quebec, Canada, H3T 1E2. Jed.lipes@mcgill.ca
Abstract
BACKGROUND: After admission to intensive care, women have higher mortality rates than do men. The reasons for the greater mortality in women are not fully understood. OBJECTIVE: To determine if increased mortality in women was due to delays in the recognition of critical illness or to delays in timely admission to intensive care. METHODS: A total of 241 consecutive admissions to intensive care from medical and surgical units during a 12-month period were analyzed retrospectively. Patients' demographics, illness severity, and delay between the time the patients would have fulfilled criteria for calling a medical emergency team and consultation with and admission to intensive care were analyzed. RESULTS: Delay from fulfillment of criteria for calling a medical emergency team and consultation with intensive care and from consultation to admission to intensive care did not differ between sexes. Despite similar delays in admission to intensive care, women had a higher 30-day mortality than did men (44.9% vs 30.5%; P = .02). The increased mortality was more pronounced in the medical patients (53% vs 34%; P = .02). Multivariate analysis of mortality data yielded a mortality odds ratio of 0.35 (95% CI, 0.16-0.74) for men, significantly different from values for women (P = .006). CONCLUSION: After admission to intensive care from medical or surgical units, women had higher mortality rates than did men, and the difference was more pronounced in medical patients. The difference in mortality between sexes was not explained by delayed recognition of critical illness or delayed admission to intensive care.
BACKGROUND: After admission to intensive care, women have higher mortality rates than do men. The reasons for the greater mortality in women are not fully understood. OBJECTIVE: To determine if increased mortality in women was due to delays in the recognition of critical illness or to delays in timely admission to intensive care. METHODS: A total of 241 consecutive admissions to intensive care from medical and surgical units during a 12-month period were analyzed retrospectively. Patients' demographics, illness severity, and delay between the time the patients would have fulfilled criteria for calling a medical emergency team and consultation with and admission to intensive care were analyzed. RESULTS: Delay from fulfillment of criteria for calling a medical emergency team and consultation with intensive care and from consultation to admission to intensive care did not differ between sexes. Despite similar delays in admission to intensive care, women had a higher 30-day mortality than did men (44.9% vs 30.5%; P = .02). The increased mortality was more pronounced in the medical patients (53% vs 34%; P = .02). Multivariate analysis of mortality data yielded a mortality odds ratio of 0.35 (95% CI, 0.16-0.74) for men, significantly different from values for women (P = .006). CONCLUSION: After admission to intensive care from medical or surgical units, women had higher mortality rates than did men, and the difference was more pronounced in medical patients. The difference in mortality between sexes was not explained by delayed recognition of critical illness or delayed admission to intensive care.
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