The DISPARITY Study: do gender differences exist in Surviving Sepsis Campaign resuscitation bundle completion, completion of individual bundle elements, or sepsis mortality?
| Autor: | Tracy E. Madsen, Anthony M. Napoli, Esther K. Choo, Alyson J. McGregor, James Simmons, David Portelli |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Resuscitation Surviving Sepsis Campaign Sexism Early goal-directed therapy Critical Care and Intensive Care Medicine Logistic regression Sepsis Sex Factors Intensive care Internal medicine medicine Humans Hospital Mortality Intensive care medicine Aged Retrospective Studies Analysis of Variance Chi-Square Distribution business.industry Septic shock Emergency department Middle Aged medicine.disease Shock Septic Logistic Models Female Guideline Adherence business Emergency Service Hospital |
| Zdroj: | Journal of critical care. 29(3) |
| ISSN: | 1557-8615 |
| Popis: | Purpose Women in the emergency department are less likely to receive early goal directed therapy, but gender differences in the Surviving Sepsis Campaign (SSC) bundle completion have not been studied [1]. We hypothesized that women have lower SSC resuscitation bundle completion rates. Materials and methods This was a retrospective, observational study in a large urban academic ED at a national SSC site. Consecutive patients (age > 18 years) admitted to intensive care with severe sepsis or septic shock and entered into the SSC database from October 2005 to February 2012 were included. Data on overall and individual bundle elements were exported from the database. Bivariate analyses were performed with chi-square tests and t-tests. Multiple logistic regression was then performed with gender as an effect modifier. Results Eight hundred fourteen patients were enrolled. The mean age was 66 years;, 44.8% were women. There was no association between gender and bundle completion (aOR 0.83, 95% CI 0.58-1.16), controlling for age, race, Sequential Organ Failure Assessment, congestive heart failure, and coagulopathy. In-hospital mortality did not differ by gender. Women were less likely to receive antibiotics within 3 hours (60.5% vs. 68.8%, p = 0.01) and less likely to reach a target ScvO 2 > 70 (31.3% vs. 39.5%, P = .05). Conclusions There were no gender disparities in bundle completion or in-hospital mortality. Further research is needed to examine individual bundle elements and gender specific factors that may affect bundle completion and mortality. |
| Databáze: | OpenAIRE |
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