Boys have better short-term and long-term survival rates after intensive care admissions than girls

Aim: We investigated possible gender differences in paediatric intensive care morbidity-adjusted mortality. Methods: In this study, data on all 21 972 paediatric intensive care admissions in Sweden between 2008 and 2015 were analysed regarding morbidity-adjusted survival, using Cox regression, with age, gender and estimated mortality ratio as dependent variables and using the standardised mortality ratio at 90 days after admission. The data were obtained from the Swedish Intensive Care Registry. Results: We found that boys had better overall survival than girls (hazard ratio 0.91 for boys, p = 0.035). In addition, the 90-day survival was also better for boys (standardised mortality ratio 0.85 for boys versus 1.02 for girls, p = 0.0014). The survival advantage was most evident in children less than a year old and for nonsurgical patients. The male advantage was also seen in children admitted with respiratory insufficiency and seizures and was furthermore independent of any concurrent cardiac condition. We did not find any gender difference in the intensity of care or length of stay when corrected for morbidity. Conclusion: This study showed that boys have better outcomes than girls after intensive care admissions. The difference does not seem to be based on inequality of care.