The influence of gender on outcome from mechanical ventilation

Purpose: To determine the influence of gender on outcomes from mechanical ventilation (MV). Methods: Prospective inception cohort study of patients requiring mechanical ventilation in the surgical and medical ICUs of Barnes and Jewish Hospitals. Results: 357 consecutive patients were evaluated. Patient outcomes and severity of illness are shown below. Multiple logistic regression analysis, controlling for potential confounding variables, demonstrated that female patients had a significantly greater hospital mortality compared to male patients (adjusted odds ratio, 2.78; 95% confidence interval, 1.76 to 4.39; P=0.021) Female Male (n=189) (n=168) Age, yr: 62.9±16.5 61.6±17.6 APACHE II Score: 17.4±5.8 16.6±5.8 ARDS, n(%): 15(7.9) 9(5.4) COPD, n(%): 47(25.4) 36(23.2) Mortality, n(%): 53(28.0) 29(17.3)* Duration of MV, hr: 85.9±104.0 85.3±187.1 ICU length of stay, d: 6.8±7.1 5.8±6.6 Hospital length of stay, d: 14.3±12.2 13.2±11.2 Hospital charges, $: 55719±48871 51614±47781 (*P=0.021; P>0.15 for all other comparisons). Conclusions: Female patients requiring mechanical ventilation have a greater risk of hospital mortality compared to male patients. Clinical Implications: Physicians should be aware of potential outcome differences between genders when assessing or designing clinical trials involving mechanical ventilation.