Universität zu Köln

van Vught, Lonneke A., Scicluna, Brendon P., Wiewel, Maryse A., Hoogendijk, Arie J., Klouwenberg, Peter M. C. Klein, Ong, David S. Y., Cremer, Olaf L., Horn, Janneke, Franitza, Marek, Toliat, Mohammad R., Nuernberg, Peter, Bonten, Marc M. J., Schultz, Marcus J. and van der Poll, Tom (2017). Association of Gender With Outcome and Host Response in Critically Ill Sepsis Patients. Crit. Care Med., 45 (11). S. 1854 - 1863. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1530-0293

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Abstract

Objective: To determine the association of gender with the presentation, outcome, and host response in critically ill patients with sepsis. Design and Setting: A prospective observational cohort study in the ICU of two tertiary hospitals between January 2011 and January 2014. Patients: All consecutive critically ill patients admitted with sepsis, involving 1,815 admissions (1,533 patients). Interventions: The host response was evaluated on ICU admission by measuring 19 plasma biomarkers reflecting organ systems implicated in sepsis pathogenesis (1,205 admissions) and by applying genome-wide blood gene expression profiling (582 admissions). Measurements and Main Results: Sepsis patients admitted to the ICU were more frequently males (61.0%; p < 0.0001 vs females). Baseline characteristics were not different between genders. Urosepsis was more common in females; endocarditis and mediastinitis in men. Disease severity was similar throughout ICU stay. Mortality was similar up to 1 year after ICU admission, and gender was not associated with 90-day mortality in multivariate analyses in a variety of subgroups. Although plasma proteome analyses (including systemic inflammatory and cytokine responses, and activation of coagulation) were largely similar between genders, females showed enhanced endothelial cell activation; this difference was virtually absent in patients more than 55 years old. More than 80% of the leukocyte blood gene expression response was similar in male and female patients. Conclusions: The host response and outcome in male and female sepsis patients requiring ICU admission are largely similar.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code van Vught, Lonneke A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scicluna, Brendon P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiewel, Maryse A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoogendijk, Arie J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klouwenberg, Peter M. C. Klein UNSPECIFIED UNSPECIFIED UNSPECIFIED Ong, David S. Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cremer, Olaf L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horn, Janneke UNSPECIFIED UNSPECIFIED UNSPECIFIED Franitza, Marek UNSPECIFIED UNSPECIFIED UNSPECIFIED Toliat, Mohammad R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nuernberg, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonten, Marc M. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schultz, Marcus J. UNSPECIFIED UNSPECIFIED UNSPECIFIED van der Poll, Tom UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-213379
DOI:	10.1097/CCM.0000000000002649
Journal or Publication Title:	Crit. Care Med.
Volume:	45
Number:	11
Page Range:	S. 1854 - 1863
Date:	2017
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1530-0293
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTENSIVE-CARE UNITS; IMMUNE-RESPONSE; SEX-DIFFERENCES; INFECTION; EPIDEMIOLOGY; MORTALITY; HORMONES; COHORT; STATES; AGE Multiple languages Critical Care Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21337