Gender differences in mortality and quality of life after septic shock: A post-hoc analysis of the ARISE study.

Abstract

PURPOSE:

To assess the impact of gender and pre-menopausal state on short- and long-term outcomes in patients with septic shock.

MATERIAL AND METHODS:

Cohort study of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial, an international randomized controlled trial comparing early goal-directed therapy (EGDT) to usual care in patients with early septic shock, conducted between October 2008 and April 2014. The primary exposure in this analysis was legal gender and the secondary exposure was pre-menopausal state defined by chronological age (≤ 50 years).

RESULTS:

641 (40.3%) of all 1591 ARISE trial participants in the intention-to-treat population were females and overall, 337 (21.2%) (146 females) patients were 50  years of age or younger. After risk-adjustment, we could not identify any survival benefit for female patients at day 90 in the younger (≤50 years) (adjusted Odds Ratio (aOR): 0.91 (0.46-1.89), p = .85) nor in the older (>50 years) age-group (aOR: 1.10 (0.81-1.49), p = .56). Similarly, there was no gender-difference in ICU, hospital, 1-year mortality nor quality of life measures.

CONCLUSIONS:

This post-hoc analysis of a large multi-center trial in early septic shock has shown no short- or long-term survival effect for women overall as well as in the pre-menopausal age-group.

• Authors: Nora Luethi, Michael Bailey, Alisa Higgins, Belinda Howe, Sandra Peake, Anthony Delaney, Rinaldo Bellomo, ARISE investigators
• Journal: Journal of critical care (J Crit Care) Vol. 55 Pg. 177-183 (02 2020) ISSN: 1557-8615 [Electronic] United States
• PMID: 31739087 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Early Goal-Directed Therapy
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Odds Ratio
• Premenopause
• Proportional Hazards Models
• Prospective Studies
• Quality of Life
• Resuscitation (mortality)
• Sex Factors
• Shock, Septic (mortality, psychology)
• Treatment Outcome