Study objectives: Recent studies combining medical and
surgical patients have suggested that mortality is higher for
mechanically ventilated women than for men. This study was designed to
determine whether there are gender-based differences in outcomes in
mechanically ventilated medical ICU (MICU) patients.
and setting: Prospective observational study in an MICU of a
tertiary-care academic medical center.
hundred eighty consecutive patients admitted to the MICU service and
mechanically ventilated for a minimum of 12 h.
Results: There was no difference in overall hospital
mortality rate (woman, 36.3%; men, 40.4%; p > 0.2). No differences
in mortality rates were noted after stratification based on age,
underlying comorbid condition, APACHE (acute physiology and chronic
health evaluation) II score, indication for mechanical ventilation, or
acute hepatic or renal failure. Using a multiple logistic regression
model, gender was not independently associated with hospital mortality.
No differences were found between men and women for a number of
secondary outcomes, including likelihood of undergoing weaning trials,
success of weaning trials, time between onset of mechanical ventilation
and extubation, total time on mechanical ventilation, rate of unplanned
extubations, need for reintubation or tracheostomy, or duration of MICU
and hospital stay, after the onset of mechanical ventilation. The
number and timing of orders written to withhold care were comparable
between men and women.
Conclusions: Using univariate
and multivariate analyses, we found no differences in hospital
mortality rates between mechanically ventilated men and women.
Differences in the process of care or gender-based treatment bias may
explain previously reported differences in outcomes.