Does Sex Affect 30-Day Mortality in Staphylococcus Aureus Bacteremia?

Nariman Mansur PharmMSc , Rawi Hazzan MD , Mical Paul MD , Jihad Bishara MD , Leonard Leibovici MD
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引用次数: 23

Abstract

Background

Sex-related differences in complications and mortality of infection were examined with conflicting results. Further studies are required to bring new light in this topic in Staphylococcus aureus infections.

Objective

We examined the outcomes of S. aureus infection in men and in women and whether sex-related differences were explained by underlying disorders, severity of disease, or clinical management.

Methods

This cohort study was conducted in a single center between 1988 and 2007. Patients with clinically significant S. aureus bacteremia were included. We compared 30-day all-cause mortality in men and women. We used multivariable logistic regression analysis to test whether sex was independently associated with mortality.

Results

One thousand ninety-three patients were identified with S. aureus bacteremia. All-cause mortality at day 30 was 39.3% (508 of 1293 patients): 44.8% (238 of 531 patients) in women and 35.4% (270 of 762 patients) in men (P < 0.01). In a multivariate analysis, female sex was associated with higher mortality (odds ratio = 1.63; 95% CI, 1.07–2.47). The excess mortality in women was not explained by differences in demographic characteristic factors, background conditions, infection severity and management, or septic complications.

Conclusions

We found that women with S. aureus bacteremia had a greater risk of 30-day all-cause mortality than men, even when adjusting for other risk factors. However, we failed to explain this excess of mortality.

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性别是否影响金黄色葡萄球菌菌血症患者的30天死亡率?
研究背景感染并发症和死亡率的性别相关差异,结果相互矛盾。在金黄色葡萄球菌感染中,需要进一步的研究来揭示这一主题。目的:我们研究了男性和女性金黄色葡萄球菌感染的结果,以及性别相关的差异是否可以用潜在疾病、疾病严重程度或临床管理来解释。方法本研究于1988年至2007年在单一中心进行。包括临床显著的金黄色葡萄球菌菌血症患者。我们比较了男性和女性的30天全因死亡率。我们使用多变量逻辑回归分析来检验性别是否与死亡率独立相关。结果共检出1393例金黄色葡萄球菌菌血症。第30天的全因死亡率为39.3%(1293例患者中有508例),女性为44.8%(531例患者中有238例),男性为35.4%(762例患者中有270例)(P <0.01)。在多变量分析中,女性与较高的死亡率相关(优势比= 1.63;95% ci, 1.07-2.47)。妇女的高死亡率不能用人口统计学特征因素、背景条件、感染严重程度和管理或脓毒性并发症的差异来解释。结论:我们发现患有金黄色葡萄球菌菌血症的女性30天全因死亡率高于男性,即使在调整了其他危险因素后也是如此。然而,我们未能解释这种死亡率过高的现象。
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来源期刊
Gender Medicine
Gender Medicine 医学-医学:内科
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