Excess mortality in women with hospital-acquired bloodstream infection.
OBJECTIVE
We examined the outcomes of bloodstream infection in men and in women and whether any sex-related differences were explained by underlying disorders, severity of disease, or clinical management.


METHODS
Using a prospectively collected database, we compared in-hospital mortality in men and women. We used multivariable logistic regression analysis to test whether sex-related differences could be due to potential confounders.


RESULTS
Of 4250 patients with bloodstream infections, 1750 (41%) had hospital-acquired infections. The overall case fatality was 31% (625 of 2032) in women and 29% (631 of 2218, P = 0.1) in men. However, 43% (325/758) of the women with hospital-acquired infections died, compared with 33% (327/992) of the men (P = 0.0001). In a multivariate analysis, female sex was associated with greater mortality in patients with hospital-acquired infections (odds ratio = 1.7; 95% confidence interval: 1.1 to 2.6). The excess mortality in women was mainly seen in patients with major underlying disorders (fatality rate of 45% [234 of 525] in women vs. 32% in men [234 of 743, P = 0.0001).


CONCLUSIONS
Mortality in women with hospital-acquired bloodstream infections is substantially greater than in men. The excess mortality was concentrated in women with severe underlying disorders, suggesting that sepsis might have accentuated differences in the outcome of underlying disorders in women.
Leibovici
L
L
Department of Medicine, Rabin Medical Center, Beilinson Campus, Petah-Tiqva, Israel.
Paul
M
M
Weinberger
M
M
Koenigsberger
H
H
Drucker
M
M
Samra
Z
Z
Yahav
J
J
Pitlik
S D
SD
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015986:Confounding Factors, Epidemiologic; D003428:Cross Infection / Q000209:etiology / Q000401:mortality*; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000401:mortality*; D012720:Severity of Illness Index; D017678:Sex Distribution