Sammanfattning
Purpose: To compare management and outcomes for critically ill women and men with sepsis in the emergency medical services (EMS), the emergency department (ED) and the ICU. Methods: We used two prospectively compiled Swedish national quality registers, the National Quality Sepsis Registry and the Swedish Intensive Care Registry to identify a nationwide cohort of 2720 adults admitted to an ICU within 24 h of arrival to any of 32 EDs, with a diagnosis of severe sepsis or septic shock between 2008 and 2015. Results: Patients were 44.5% female. In the EMS, a higher fraction of men had all vital signs recorded—54.4 vs 49.9% (p = 0.02) and received IV fluids and oxygen—40.0 vs 34.8% (p = 0.02). In the ED, men had completed 1-h sepsis bundles in 41.5% of cases compared to 30.0% in women (p < 0.001), and shorter time to antibiotics—65 (IQR 30–136) vs 87 min (IQR 39–172) (p = 0.0001). There was no significant difference between men and women regarding ICU nursing workload, mechanical ventilation or ICU length of stay. In severity-adjusted multivariable analysis, OR for women achieving a completed sepsis bundle, compared to men was 0.64 (CI 0.51–0.81). Thirty-day mortality was 25.0% for women and 23.1% for men (p = 0.24). Adjusted OR for female death was 1.28 (CI 1.00–1.64), but the increased mortality was not mediated by differential bundle completion. Conclusions: Women and men with severe sepsis or septic shock received differential care in the ED, but this did not explain higher odds of death in women.
Originalspråk | engelska |
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Sidor (från-till) | 727-736 |
Antal sidor | 10 |
Tidskrift | Intensive Care Medicine |
Volym | 46 |
Nummer | 4 |
Tidigt onlinedatum | 2020 jan. 23 |
DOI | |
Status | Published - 2020 apr. |
Ämnesklassifikation (UKÄ)
- Infektionsmedicin
- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Fingeravtryck
Utforska forskningsämnen för ”Sex-based differences in ED management of critically ill patients with sepsis: a nationwide cohort study”. Tillsammans bildar de ett unikt fingeravtryck.Utrustning
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Lund University Population Research Platform
Axmon, A. (Manager) & Stroh, E. (Manager)
Lunds universitetInfrastruktur