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Clinical Investigations in Critical CareLack of Influence of Gender on Outcomes of Mechanically Ventilated Medical ICU Patients
Section snippets
Patient Selection
Our hypothesis was that outcomes for mechanically ventilated men and women, in an MICU, would be similar if there were comparable degrees of severity of illness and if the process of care was equivalent. Therefore, we conducted a prospective observational study at a tertiary-care, university-affiliated teaching hospital (New England Medical Center). All patients who were admitted to the Medical ICU Service and who were intubated and mechanically ventilated for a minimum of 12 h were entered
Results
The study population consisted of 330 men (57%) and 250 women (43%). Tables 1 and 2 show baseline characteristics of these two groups. No differences were found in age, indication for mechanical ventilation, or APACHE II scores. While similar percentages of men and women had diabetes mellitus, chronic renal insufficiency, chronic congestive heart failure, and organ transplantation, men were more likely to have active malignancy and COPD, and to be HIV positive. While no difference in the
Discussion
A number of previous studies have suggested increased mortality rates for critically ill women compared to critically ill men.12346 The majority of these studies have been conducted in surgical patients, in mixed populations of ICU patients, or in those patients primarily having cardiovascular disease. Recently, rigorously conducted studies have questioned the validity of the findings among patients with cardiovascular disease. Koch et al7 found that gender was not an independent risk factor
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