Gender differences in the provision of intensive care: a Bayesian approach

Todorov, A. and Kaufmann, F. and Arslani, K. and Haider, A. and Bengs, S. and Goliasch, G. and Zellweger, N. and Tontsch, J. and Sutter, R. and Buddeberg, B. and Hollinger, A. and Zemp, E. and Kaufmann, M. and Siegemund, M. and Gebhard, C. and Gebhard, C. E. and Swiss Society of Intensive Care Medicine, . (2021) Gender differences in the provision of intensive care: a Bayesian approach. Intensive Care Med, 47 (5). pp. 577-587.

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PURPOSE: It is currently unclear whether management and outcomes of critically ill patients differ between men and women. We sought to assess the influence of age, sex and diagnoses on the probability of intensive care provision in critically ill cardio- and neurovascular patients in a large nationwide cohort in Switzerland. METHODS: Retrospective analysis of 450,948 adult patients with neuro- and cardiovascular disease admitted to all hospitals in Switzerland between 01/2012 and 12/2016 using Bayesian modeling. RESULTS: For all diagnoses and populations, median ages at admission were consistently higher for women than for men [75 (64;82) years in women vs. 68 (58;77) years in men, p 65 years (OR women:men 0.94 (0.89-0.99), p < 0.001). Women < 45 years had a similar ICU admission probability as men in the same age category [OR women:men 1.03 (0.94-1.13)], in spite of more severe illness. The odds to die were significantly higher in women than in men per unit increase in Simplified Acute Physiology Score (SAPS) II (OR 1.008 [1.004-1.012]). CONCLUSION: In the care of the critically ill, our study suggests that women are less likely to receive ICU treatment regardless of disease severity. Underuse of ICU care was most prominent in younger women < 45 years. Although our study has several limitations that are imposed by the limited data available from the registries, our findings suggest that current ICU triage algorithms could benefit from careful reassessment. Further, and ideally prospective, studies are needed to confirm our findings.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Gender and Health (Zemp Stutz)
UniBasel Contributors:Zemp Stutz, Elisabeth
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1432-1238 (Electronic)0342-4642 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:21 Dec 2022 12:36
Deposited On:21 Dec 2022 12:36

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