Influence of Gender on Outcome of Severe Sepsis
Whether gender influences the outcome of severe sepsis remains a matter of debate. Because many confounding variables may affect observed associations between gender and mortality, high-quality statistical analyses are essential to carefully adjust the two groups of patients. About 55% to 65% of patients with sepsis have chronic co-morbidities associated with immune dysfunction (e.g., chronic renal failure, diabetes mellitus, human immunodeficiency virus [HIV] infection, and alcohol abuse), which increase the susceptibility to sepsis . Genetic polymorphisms that affect the susceptibility to infection and/or the severity of the systemic response to infection  may lead to variability among individuals and between males and females . Access to healthcare, another determinant of the incidence and outcome of sepsis, varies according to age, ethnic group, and gender, although a recent study conducted in the USA found only relatively small quality-of-care differences between males and females or across income groups compared to the gap for each subgroup between observed and desirable quality of health care . Here, we review the data on the existence of, and reasons for, associations between gender and outcome of severe sepsis (Fig. 1).
KeywordsSevere Sepsis Acute Lung Injury Aromatase Activity Lipopolysaccharide Binding Protein Serum Estradiol Concentration
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