Sex differences in children with severe health conditions: Causes of admission and mortality in a Pediatric Intensive Care Unit

Esteban, Elisabeth; Bujaldon, Esther; Esparza, Mireia; Jordán, Iolanda; Esteban, Esther

doi:10.1002/ajhb.22709

Cited by 21 publications

(23 citation statements)

References 20 publications

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“…Neither did they consider possible differences in severity of illness. In a Spanish study of 2 609 PICU patients, Esteban et al revealed higher rates of hospitalisation for boys, and female gender as a risk factor for mortality, after correcting for a number of factors such as inotropic support, etc., all in line with the present study. In contrast with the present study, however, they hypothesised that the younger age and the higher rates of nosocomial infections in the girls could explain the difference.…”

Section: Discussionmentioning

confidence: 99%

“…By using a logistic regression model, they did not find race or ethnicity to be a mortality factor but, after correcting for severity of illness, the female gender was found to be a significant factor for mortality, although gender was not in focus in this study. In a single‐centre study of 2 609 PICU patients in Spain, Esteban et al found that female gender was a negative survival factor (odds ratio 1.55, p = 0.033).…”

Section: Introductionmentioning

confidence: 99%

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Boys have better short‐term and long‐term survival rates after intensive care admissions than girls

2017

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Aim:We investigated possible gender differences in paediatric intensive care morbidityadjusted mortality.Methods: In this study, data on all 21 972 paediatric intensive care admissions in Sweden between 2008 and 2015 were analysed regarding morbidity-adjusted survival, using Cox regression, with age, gender and estimated mortality ratio as dependent variables and using the standardised mortality ratio at 90 days after admission. The data were obtained from the Swedish Intensive Care Registry.Results: We found that boys had better overall survival than girls (hazard ratio 0.91 for boys, p = 0.035). In addition, the 90-day survival was also better for boys (standardised mortality ratio 0.85 for boys versus 1.02 for girls, p = 0.0014). The survival advantage was most evident in children less than a year old and for nonsurgical patients. The male advantage was also seen in children admitted with respiratory insufficiency and seizures and was furthermore independent of any concurrent cardiac condition. We did not find any gender difference in the intensity of care or length of stay when corrected for morbidity. Conclusion:This study showed that boys have better outcomes than girls after intensive care admissions. The difference does not seem to be based on inequality of care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Boys have better short‐term and long‐term survival rates after intensive care admissions than girls

2017

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“…In this study we have analyzed the demographic characteristics of a sample of children with severe trauma to determine the type of events causing these injuries, and to measure the contribution of sex and age in each type of injury. A previous study published in 2015 in the same pediatric population indicated that boys suffered more severe trauma events than girls, but we were not able to stratify those injuries into specific causes by sex and age [15]. Thanks to the Hospital Sant Joan de Déu's participation in a trauma registry (TraumCat) that collects hospital based information of severe trauma patients in Catalonia (Spain), we have had access to a detailed database of pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…After the univariate analysis of data, a binary logistic forward regression was performed to establish whether sex and age were risk factors for severe trauma. To carry out this analysis, the database of pediatric patients of Esteban et al [15] was used. Girls and neonates were used as the reference group.…”

Section: Methodsmentioning

confidence: 99%

“…In 2015 we analyzed a large sample of children admitted in a pediatric intensive care unit to explore the role of severe stress on sex-related survival. Although girls seemed to be more vulnerable because of a wider range of hospital admission causes, the proportion of boys exceeded the proportion of girls in admissions due to multiple trauma [15]).…”

Section: Introductionmentioning

confidence: 99%

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Pattern of severe injuries in Spanish children: boys and falls are alarmingly overrepresented

Benito

López-Parellada

Esteban

et al. 2018

Preprint

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Background: Taking into account that injury is one of the main causes of child fatalities in developed countries, and that boys are more likely to suffer it than girls, we have explored a database of pediatric patients with severe injuries to determine whether sex and age influence the pattern of these fatalities, and the magnitude of this. Method:Observational study of the demographic and clinical characteristics of 227 patients from a Spanish pediatric reference hospital, all of them admitted with a diagnosis of trauma.Result: Falls are the most frequent type of trauma (60.7%), followed by pedestrian traffic collisions (15%). Boys are over-represented in falls (72% vs 28% in girls) and pedestrian traffic injuries (61% vs 39 %). In boys, falls are mainly observed in public roads and during leisure activities (53.8%) whereas in girls at home (55.2%). In a logistic regression, sex and age are statistically significant predictors of severe trauma, boys (OR = 1.59) and the adolescent age group (OR = 3.7) showed the highest odds. Conclusion:We have observed a clear gender-biased pattern of injury-related events: falls are the leading cause of injuries, with 2.5 boys for every girl. Falls mostly happened during outdoor leisure activities in boys and at home in girls. Pedestrian traffic injuries also show significant differences between sexes, emphasizing the role of cognitive and cultural factors in children's behavior. 3 WHAT IS ALREADY KNOWN ON THE SUBJECT In 2016 road injuries were the third cause of death among children from 5 to 9 years old in the OCDE countries. Road traffic injuries and falls are the most relevant sources of unintentional trauma.  Injury-related events are gender-biased, with boys suffering more frequent and severe events than girls. But there are few studies indicating whether this sex biased pattern is present in all types of trauma. WHAT THIS STUDY ADDS Sex and age are statistically significant predictors of severe trauma in children. Boys show 2.5 times more severe falls than girls, mainly during outdoor leisure activities. Cognitive and cultural factors may explain the remarkable age differences observed between boys and girls in pedestrian traffic collisions. The relatively high proportion of young girls involved in falls from great heights needs to be contrasted with data from comparable studies, and if this tendency is confirmed, preventive measures must be launched.

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Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16‐year tertiary single‐institution experience

Chang

Yang

et al. 2017

Pediatric Blood & Cancer

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Sex differences in children with severe health conditions: Causes of admission and mortality in a Pediatric Intensive Care Unit

Cited by 21 publications

References 20 publications

Boys have better short‐term and long‐term survival rates after intensive care admissions than girls

Boys have better short‐term and long‐term survival rates after intensive care admissions than girls

Pattern of severe injuries in Spanish children: boys and falls are alarmingly overrepresented

Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16‐year tertiary single‐institution experience

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