title: Gender-related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study.
abstract: BACKGROUND
  Impact of gender on severe infections is in highly controversial discussion with natural survival advantage of females described in animal studies but contradictory to those described human data. This study aims to describe the impact of gender on outcome in mixed intensive care units (ICUs) with a special focus on sepsis.
  
  
  METHODS
  We performed a prospective, observational, clinical trial at Charité University Hospital in Berlin, Germany. Over a period of 180 days, patients were screened, undergoing care in three mainly surgical ICUs. In total, 709 adults were included in the analysis, comprising the main population ([female] n = 309, [male] n = 400) including 327 as the sepsis subgroup ([female] n = 130, [male] n = 197).
  
  
  RESULTS
  Basic characteristics differed between genders in terms of age, lifestyle factors, comorbidities, and SOFA-score (Sequential Organ Failure Assessment). Quality and quantity of antibiotic therapy in means of antibiotic-free days, daily antibiotic use, daily costs of antibiotics, time to antibiotics, and guideline adherence did not differ between genders. ICU mortality was comparable in the main population ([female] 10.7% versus [male] 9.0%; P = 0.523), but differed significantly in sepsis patients with [female] 23.1% versus [male] 13.7% (P = 0.037). This was confirmed in multivariate regression analysis with OR = 1.966 (95% CI, 1.045 to 3.701; P = 0.036) for females compared with males.
  
  
  CONCLUSIONS
  No differences in patients' outcome were noted related to gender aspects in mainly surgical ICUs. However, for patients with sepsis, an increase of mortality is related to the female sex.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Charité Universitaetsmedizin Berlin, Campus Charité Mitte, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Irit
authors.initials: I
authors.lastname: Nachtigall
authors.forename: Sascha
authors.initials: S
authors.lastname: Tafelski
authors.forename: Andreas
authors.initials: A
authors.lastname: Rothbart
authors.forename: Lutz
authors.initials: L
authors.lastname: Kaufner
authors.forename: Maren
authors.initials: M
authors.lastname: Schmidt
authors.forename: Andrey
authors.initials: A
authors.lastname: Tamarkin
authors.forename: Maxim
authors.initials: M
authors.lastname: Kartachov
authors.forename: Daniela
authors.initials: D
authors.lastname: Zebedies
authors.forename: Tanja
authors.initials: T
authors.lastname: Trefzer
authors.forename: Klaus-Dieter
authors.initials: KD
authors.lastname: Wernecke
authors.forename: Claudia
authors.initials: C
authors.lastname: Spies
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000401:mortality* / Q000628:therapy*; D012727:Sex Characteristics; D016896:Treatment Outcome