Sex, age, and critical illness: a tangled web.

Abstract

In a comprehensive, nationwide cohort of intensive care patients in Sweden, female patients had higher adjusted mortality than male patients, a difference driven by the subgroup of patients aged >51 yr. The authors demonstrate a complex relationship between patient sex and outcomes across the lifespan, which could reflect changing concentrations of sex hormones with age, and gender differences in the incidence of limitations to life-sustaining therapy. In their study cohort, female patients received fewer interventions in the ICU and had worse outcomes overall than male patients, suggesting relative undertreatment of female patients. Further sex- and gender-sensitive research is urgently required to understand this apparent inequity in treatment, and to guide sex-specific treatment strategies in critically ill patients.