Acute respiratory failure: a gender-based outcomes analysis.
OBJECTIVE
To determine the influence of gender on patient outcomes and the delivery of medical care during mechanical ventilation for acute respiratory failure.


METHODS
A prospective cohort study.


METHODS
Medical intensive care unit of a university-affiliated urban teaching hospital.


METHODS
Three hundred twenty-one patients with acute respiratory failure requiring mechanical ventilation.


METHODS
Prospective patient surveillance and data collection.


RESULTS
One hundred six patients (33.0%) died during hospitalization. No statistically significant difference in mortality rates was observed between male and female patients (36.1% versus 30.1%; P = .252). The duration of mechanical ventilation, intensive care unit length of stay, and hospital length of stay were also similar between men and women with acute respiratory failure. The presence of the acute respiratory distress syndrome (ARDS; adjusted odds ratio [AOR] = 3.65; 95% confidence interval [CI] = 2.34 to 5.71; P = .004), the number of acquired organ system derangements (AOR = 1.36; 95% CI = 1.20 to 1.53; P = .013), the predicted hospital mortality using acute physiology and chronic health evaluation (APACHE) II scores (AOR = 1.05; 95% CI = 1.04 to 1.05; P < .001), and patient age (AOR = 1.02; 95% CI = 1.01 to 1.03; P = .016) were found to be independent determinants of hospital mortality using multiple logistic regression analysis.


CONCLUSIONS
These data suggest that important gender-specific differences in outcome do not occur among patients with respiratory failure requiring mechanical ventilation. Severity of illness, patient age, and acquired organ system derangements appear to be the most important determinants of mortality for patients with acute respiratory failure, regardless of patient gender.
Pulmonary and Critical Care Division, Washington University School of Medicine, Campus Box 8052, 660 S Euclid Ave, St. Louis, MO 63110, USA. mkollef@pulmonary.wustl.edu
M H
MH
Kollef
D018806:APACHE; D000208:Acute Disease; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012131:Respiratory Insufficiency / Q000401:mortality* / Q000628:therapy*; D012737:Sex Factors