Rationale: Women have worse outcomes than men in several conditions more common in men, including cardiac surgery and burns. Objectives: To describe the relationship between sex balance within each diagnostic group of ICU admissions, defined as the percentage of patients who were women, and hospital mortality of women compared with men with that same diagnosis. Methods: We studied ICU patients in the Australian and New Zealand Intensive Care Society's Adult Patient Database (2011-2020). We performed mixed effects logistic regression for hospital mortality adjusted for sex, illness severity, ICU lead time, admission year, and hospital site. We compared sex balance with the adjusted hospital mortality of women compared with men for each diagnosis using weighted linear regression. Measurements and Main Results: There were 1,450,782 admissions (42.1% women), with no difference in the adjusted hospital mortality of women compared with men overall (odds ratio, 0.99; 99% confidence interval [CI], 0.97 to 1). As the percentage of women within each diagnosis increased, the adjusted mortality of women compared with men with that same diagnosis decreased (regression coefficient, -0.015; 99% CI; -0.020 to -0.011; P < 0.001), and the illness severity of women compared with men at ICU admission decreased (regression coefficient, -0.0026; 99% CI, -0.0035 to -0.0018; P < 0.001). Conclusions: Sex balance in diagnostic groups was inversely associated with both the adjusted mortality and illness severity of women compared with men. In diagnoses with relatively few women, women were more likely than men to die. In diagnoses with fewer men, men were more likely than women to die.

中文翻译：

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根据诊断相关的性别平衡，ICU 患者死亡率的性别差异。


理由：在男性更常见的几种情况下，女性的预后比男性差，包括心脏手术和烧伤。目的：描述 ICU 入院的每个诊断组内的性别平衡（定义为女性患者的百分比）与具有相同诊断的女性与男性相比的医院死亡率之间的关系。方法：我们研究了澳大利亚和新西兰重症监护协会成人患者数据库（2011-2020 年）中的 ICU 患者。我们对医院死亡率进行了混合效应逻辑回归，并根据性别、疾病严重程度、ICU 准备时间、入院年份和医院地点进行了调整。我们使用加权线性回归将每次诊断的性别平衡与女性与男性的调整后医院死亡率进行比较。测量和主要结果：入院人数为 1,450,782 人（42.1% 为女性），总体而言，女性调整后的医院死亡率与男性相比没有差异（比值比，0.99；99% 置信区间 [CI]，0.97 至 1）。随着每次诊断中女性比例的增加，与具有相同诊断的男性相比，女性的调整死亡率下降（回归系数，-0.015；99% CI；-0.020 至 -0.011；P < 0.001），并且疾病严重程度与男性相比，入住 ICU 的女性比例有所下降（回归系数，-0.0026；99% CI，-0.0035 至 -0.0018；P < 0.001）。结论：与男性相比，诊断组中的性别平衡与女性调整后的死亡率和疾病严重程度呈负相关。在女性相对较少的诊断中，女性比男性更有可能死亡。在男性较少的诊断中，男性比女性更有可能死亡。