Key result
Male gender is linked to ~15% higher in-hospital mortality in sepsis, varying by age.
Why the study?
Epidemiological studies investigating gender-dependent clinical outcomes in sepsis have shown conflicting evidence.
Does male gender influence in-hospital mortality in adult patients with sepsis compared to female gender?
Cohort (n=6,442)
Yes
Does male gender influence in-hospital mortality in adult patients with sepsis compared to female gender?
Gender influences age-associated sepsis outcomes, with males having higher overall in-hospital mortality but lower mortality in the 19-50 age group compared to females.
Gender modifies age-related sepsis mortality; leaves open replication before age-sex-specific risk stratification.
BACKGROUND: Numerous epidemiological studies investigating gender-dependent clinical outcomes in sepsis have shown conflicting evidence. This study aimed to investigate the effect of gender on in-hospital mortality due to sepsis according to age group. METHODS: This study used data from the Korean Sepsis Alliance, an ongoing nationwide prospective multicenter cohort from 19 participating hospitals in South Korea. All adult patients diagnosed with sepsis in the emergency departments of the participating hospitals between September 2019 and December 2021 were included in the analysis. Clinical characteristics and outcomes were compared between male and female. Eligible patients were stratified by age into 19-50 years, 50-80 years, and ≥ 80 years old individuals. RESULTS: During the study period, 6442 patients were included in the analysis, and 3650 (56.7%) were male. The adjusted odds ratio (OR) [95% confidence interval (CI)] for in-hospital mortality for male compared with female was 1.15 (95% CI = 1.02-1.29). Interestingly, in the age 19-50 group, the risk of in-hospital mortality for males was significantly lower than that of females [0.57 (95% CI = 0.35-0.93)]. For female, the risk of death remained relatively stable until around age 80 (P for linearity = 0.77), while in males, there was a linear increase in the risk of in-hospital death until around age 80 (P for linearity < 0.01). Respiratory infection (53.8% vs. 37.4%, p < 0.01) was more common in male, whereas urinary tract infection (14.7% vs. 29.8%, p < 0.01) was more common in female. For respiratory infection, male had significantly lower in-hospital mortality than female in the age 19-50 groups (adjusted OR = 0.29, 95% CI = 0.12-0.69). CONCLUSIONS: Gender may influence age-associated sepsis outcomes. Further studies are needed to replicate our findings and fully understand the interaction of gender and age on the outcomes of patients with sepsis.
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Ko et al. (2023) conducted a cohort in Sepsis and septic shock (n=6,442). Male gender vs. Female gender was evaluated on In-hospital mortality (OR 1.15, 95% CI 1.02-1.29, p=<0.01). Male gender was associated with a significantly higher overall odds of in-hospital mortality compared to female gender in patients with sepsis (OR 1.15), although this effect varied significantly by age.
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