This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (39)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Pneumonia  • Bacterial Infections  • Infectious Diseases, Other  • Alert me on articles by topic

Traves D. Crabtree, MD; Shawn J. Pelletier, MD; Thomas G. Gleason, MD; Timothy L. Pruett, MD; Robert G. Sawyer, MD

JAMA. 1999;282:2143-2148.

Context  While it is established that management strategies and outcomes differ by gender for many diseases, its effect on infection has not been adequately studied.

Objective  To investigate the role of gender among hospitalized patients treated for infection.

Design  Observational cohort study conducted during a 26-month period from December 1996 through January 1999.

Setting  University-affiliated hospital.

Participants  A total of 892 patients in the surgical units of the hospital with 1470 consecutive infectious episodes (782 in men and 688 in women).

Main Outcome Measures  Mortality during hospitalization by gender for infection episodes overall and for specific infectious sites, including lung, peritoneum, bloodstream, catheter, urine, surgical site, and skin/soft tissue.

Results  Among all infections, there was no significant difference in mortality based on gender (men, 11.1% vs women, 14.2%; P = .07). After logistic regression analysis, factors independently associated with mortality included higher APACHE (Acute Physiology and Chronic Health Evaluation) II score, older age, malignancy, blood transfusion, and diagnosis of infection more than 7 days after admission, but not gender (female odds ratio [OR] for death, 1.32; 95% confidence interval [CI], 0.90-1.94; P = .16). Mortality was higher in women for lung (men, 18% vs women, 34%; P = .002) and soft tissue (men, 2% vs women, 10%; P.05) infection; for other infectious sites, mortality did not differ by gender. Factors associated with mortality due to pneumonia by logistic regression included higher APACHE II score, malignancy, diabetes mellitus, diagnosis of infection more than 7 days after admission, older age, transplantation, and female gender (OR for death, 2.25; 95% CI, 1.17-4.32; P = .02).

Conclusions  Although gender may not be predictive of mortality among all infections, women appear to be at increased risk for death from hospital-acquired pneumonia, even after controlling for other comorbidities.

Author Affiliations: Departments of Surgery (Drs Crabtree, Pelletier, Gleason, Pruett, and Sawyer) and Internal Medicine (Dr Pruett), University of Virginia Health Sciences Center, Charlottesville.

RELATED ARTICLE

December 8, 1999
JAMA. 1999;282(22):2183-2184.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Gender dimorphism following injury: making the connection from bench to bedside
Sperry and Minei
J. Leukoc. Biol. 2008;83:499-506.
ABSTRACT | FULL TEXT  

Sex-and age-based differences in the delivery and outcomes of critical care
Fowler et al.
CMAJ 2007;177:1513-1519.
ABSTRACT | FULL TEXT  

Sepsis and Sex: Can We Look Beyond Our Hormones?
Berkowitz and Martin
Chest 2007;132:1725-1727.
FULL TEXT  

Influence of Gender on the Outcome of Severe Sepsis: A Reappraisal
Adrie et al.
Chest 2007;132:1786-1793.
ABSTRACT | FULL TEXT  

Association Between Venous Thromboembolism and Perioperative Allogeneic Transfusion
Nilsson et al.
Arch Surg 2007;142:126-132.
ABSTRACT | FULL TEXT  

Contribution of infection to increased mortality in women after cardiac surgery.
Rogers et al.
Arch Intern Med 2006;166:437-443.
ABSTRACT | FULL TEXT  

Effect of Patient Sex on Intensive Care Unit Survival
Romo et al.
Arch Intern Med 2004;164:61-65.
ABSTRACT | FULL TEXT  

Polymorphism in the Surfactant Protein-B Gene, Gender, and the Risk of Direct Pulmonary Injury and ARDS
Gong et al.
Chest 2004;125:203-211.
ABSTRACT | FULL TEXT  

Treatment and outcome of Pseudomonas aeruginosa bacteraemia: an antibiotic pharmacodynamic analysis
Zelenitsky et al.
J Antimicrob Chemother 2003;52:668-674.
ABSTRACT | FULL TEXT  

Hospitalized Community-acquired Pneumonia in the Elderly . Age- and Sex-related Patterns of Care and Outcome in the United States
KAPLAN et al.
Am. J. Respir. Crit. Care Med. 2002;165:766-772.
ABSTRACT | FULL TEXT  

Longer-Term Diabetic Patients Have a More Frequent Incidence of Nosocomial Infections After Elective Gastrectomy
Yamashita et al.
Anesth. Analg. 2000;91:1176-1181.
ABSTRACT | FULL TEXT  

Interleukin-1 Receptor Signaling Rather than That of Tumor Necrosis Factor Is Critical in Protecting the Host from the Severe Consequences of a Polymicrobe Anaerobic Infection
Graves et al.
Infect. Immun. 2000;68:4746-4751.
ABSTRACT | FULL TEXT