Sex-specific treatment characteristics and 30-day mortality outcomes of critically ill COVID-19 patients over 70 years of age-results from the prospective COVIP study
Wolff, Georg (Heinrich-Heine-University Düsseldorf)
Wernly, Bernhard (Paracelsus Medical University)
Flaatten, Hans (University of Bergen)
Fjølner, Jesper (Aarhus University Hospital (Aarhus, Dinamarca))
Bruno, Raphael Romano (Heinrich-Heine-University Düsseldorf)
Artigas Raventós, Antoni (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Pinto, Bernardo Bollen (Geneva University Hospitals (Ginebra, Suïssa))
Schefold, Joerg C. (University of Bern)
Kelm, Malte (Heinrich-Heine-University Düsseldorf)
Binneboessel, Stephan (Heinrich-Heine-University Düsseldorf)
Baldia, Philipp Heinrich (Heinrich-Heine-University Düsseldorf)
Beil, Michael (Hebrew University of Jerusalem)
Sivri, Sigal (Hebrew University of Jerusalem)
van Heerden, Peter Vernon (Hebrew University of Jerusalem)
Szczeklik, Wojciech (Jagiellonian University Medical College)
Elhadi, Muhammed (University of Tripoli)
Joannidis, Michael (Medical University Innsbruck)
Oeyen, Sandra (Universitair Ziekenhuis Gent)
Flamm, Maria (Paracelsus Medical University)
Zafeiridis, Tilemachos (General University Hospital of Larissa (Grècia))
Marsh, Brian (Mater Misericordiae University Hospital (Dublín, Irlanda))
Andersen, Finn H. (Norwegian University of Science and Technology)
Moreno, Rui (Nova Medical School)
Boumendil, Ariane (Sorbonne Universités)
De Lange, Dylan W. (University Medical Center)
Guidet, Bertrand (Sorbonne Universités)
Leaver, Susannah (St George's University Hospitals NHS Foundation Trust)
Jung, Christian (Heinrich-Heine-University)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	Older critically ill patients with COVID-19 have been the most vulnerable during the ongoing pandemic, with men being more prone to hospitalization and severe disease than women. We aimed to explore sex-specific differences in treatment and outcome after intensive care unit (ICU) admission in this cohort. We performed a sex-specific analysis in critically ill patients ≥ 70 yr of age with COVID-19 who were included in the international prospective multicenter COVIP study. All patients were analyzed for ICU admission and treatment characteristics. We performed a multilevel adjusted regression analysis to elucidate associations of sex with 30-day mortality. A total of 3,159 patients (69. 8% male, 30. 2% female; median age, 75 yr) were included. Male patients were significantly fitter than female patients as determined by the Clinical Frailty Scale (fit, 67% vs 54%; vulnerable, 14% vs 19%; frail, 19% vs 27%; P < 0. 001). Male patients more often underwent tracheostomy (20% vs 14%; odds ratio [OR], 1. 57; P < 0. 001), vasopressor therapy (69% vs 62%; OR, 1. 25; P = 0. 02), and renal replacement therapy (17% vs 11%; OR, 1. 96; P < 0. 001). There was no difference in mechanical ventilation, life-sustaining treatment limitations, and crude 30-day mortality (50% male vs 49% female; OR, 1. 11; P = 0. 19), which remained true after adjustment for disease severity, frailty, age and treatment limitations (OR, 1. 17; 95% confidence interval, 0. 94 to 1. 45; P = 0. 16). In this analysis of sex-specific treatment characteristics and 30-day mortality outcomes of critically ill patients with COVID-19 ≥ 70 yr of age, we found more tracheostomy and renal replacement therapy in male vs female patients, but no significant association of patient sex with 30-day mortality. (NCT04321265); registered 25 March 2020). The online version contains supplementary material available at 10. 1007/s12630-022-02304-2.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	COVID ; COVIP ; Critical illness ; Elderly ; Mortality ; Sex
Publicado en:	Canadian journal of anesthesia, august 2022, p. 1-9, ISSN 1496-8975

DOI: 10.1007/s12630-022-02304-2
PMID: 35945477

9 p, 295.2 KB

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