AI Article Synopsis
- - The study aimed to determine if sex is an independent factor influencing mortality rates in ICU patients with sepsis through a systematic review and meta-analysis of existing research.
- - The analysis included 13 studies with over 80,000 participants but found no significant sex-based differences in overall hospital or ICU mortality, although it indicated that females had a higher risk of 28-day mortality but a lower risk of 1-year mortality.
- - Overall, the findings suggest that the effect of sex on mortality is uncertain, with concerns about the quality and consistency of the evidence affecting conclusions.
Article Abstract
Objective: To assess the role of sex as an independent prognostic factor for mortality in patients with sepsis admitted to intensive care units (ICUs).
Design: Systematic review and meta-analysis.
Data Sources: MEDLINE, Embase, Web of Science, ClinicalTrials.gov and the WHO Clinical Trials Registry from inception to 17 July 2020.
Study Selection: Studies evaluating independent associations between sex and mortality in critically ill adults with sepsis controlling for at least one of five core covariate domains prespecified following a literature search and consensus among experts.
Data Extraction And Synthesis: Two authors independently extracted and assessed the risk of bias using Quality In Prognosis Studies tool. Meta-analysis was performed by pooling adjusted estimates. The Grades of Recommendations, Assessment, Development and Evaluation approach was used to rate the certainty of evidence.
Results: From 14 304 records, 13 studies (80 520 participants) were included. Meta-analysis did not find sex-based differences in all-cause hospital mortality (OR 1.02, 95% CI 0.79 to 1.32; very low-certainty evidence) and all-cause ICU mortality (OR 1.19, 95% CI 0.79 to 1.78; very low-certainty evidence). However, females presented higher 28-day all-cause mortality (OR 1.18, 95% CI 1.05 to 1.32; very low-certainty evidence) and lower 1-year all-cause mortality (OR 0.83, 95% CI 0.68 to 0.98; low-certainty evidence). There was a moderate risk of bias in the domain adjustment for other prognostic factors in six studies, and the certainty of evidence was further affected by inconsistency and imprecision.
Conclusion: The prognostic independent effect of sex on all-cause hospital mortality, 28-day all-cause mortality and all-cause ICU mortality for critically ill adults with sepsis was uncertain. Female sex may be associated with decreased 1-year all-cause mortality.
Prospero Registration Number: CRD42019145054.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461281 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2021-048982 | DOI Listing |
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