TY - JOUR
T1 - Gender-based differences in children with sepsis and ARDS: The ESPNIC ARDS Database Group
AU - Bindl, Lutz
AU - Buderus, Stephan
AU - Dahlem, Peter
AU - Demirakca, Sueha
AU - Goldner, Martin
AU - Huth, Ralf
AU - Kohl, Martina
AU - Krause, Martin
AU - Kühl, Peter
AU - Lasch, Peter
AU - Lewandowski, Klaus
AU - Merz, Ulrich
AU - Moeller, Jens
AU - Mohamad, Yehya
AU - Peters, Mark
AU - Porz, Wolfgang
AU - Vierzig, Anne
AU - Rüchard, Jochen
AU - Scharf, Jochem
AU - Varnholt, Verena
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2003/10
Y1 - 2003/10
N2 - Male gender predisposes to severe sepsis and septic shock. This effect has been ascribed to higher levels of testosterone. The ESPNIC ARDS database was searched, to determine if there was evidence of a similar male preponderance in severe sepsis in prepubertal patients in spite of low levels of male sex hormones at this age. A total of 72 patients beyond neonatal age up to 8 years of age with sepsis were identified. The male/female (M/F) ratio was 1.7 (1.0;2.7) and differed significantly from non-septic ARDS patients in this age group [n = 209; M/F = 1.0 (0.8;1.3)]. The highest M/F-ratio was observed in the first year of life. The gender-ratio was the same as reported in adult patients with sepsis. In infants between 1 month and 12 months of age, the ratio was 2.8 (1.2;6.1) (Chi2= 5.6; P< 0.01), in children from 1 year to 8 years of age it was 1.2 (0.7;2.2) (n.s.). In a subgroup of patients with severe sepsis or septic shock, caused by other bacteria than Neisseria meningitidis, the M/F-ratio was 2.1 (1.2;3.6) (Chi2= 4.9; P<0.05), while in patients with meningococcal sepsis (n=20) the M/F-ratio was 1.0 (0.4;2.3). In prepubertal ARDS patients with sepsis an increased frequency of male patients is found, comparable to adults. No male preponderance exists in patients with ARDS due to meningococcal septic shock. Since levels of testosterone and other sex hormones are extremely low at this age, we conclude that factors others than testosterone are involved in the male preponderance in severe sepsis.
AB - Male gender predisposes to severe sepsis and septic shock. This effect has been ascribed to higher levels of testosterone. The ESPNIC ARDS database was searched, to determine if there was evidence of a similar male preponderance in severe sepsis in prepubertal patients in spite of low levels of male sex hormones at this age. A total of 72 patients beyond neonatal age up to 8 years of age with sepsis were identified. The male/female (M/F) ratio was 1.7 (1.0;2.7) and differed significantly from non-septic ARDS patients in this age group [n = 209; M/F = 1.0 (0.8;1.3)]. The highest M/F-ratio was observed in the first year of life. The gender-ratio was the same as reported in adult patients with sepsis. In infants between 1 month and 12 months of age, the ratio was 2.8 (1.2;6.1) (Chi2= 5.6; P< 0.01), in children from 1 year to 8 years of age it was 1.2 (0.7;2.2) (n.s.). In a subgroup of patients with severe sepsis or septic shock, caused by other bacteria than Neisseria meningitidis, the M/F-ratio was 2.1 (1.2;3.6) (Chi2= 4.9; P<0.05), while in patients with meningococcal sepsis (n=20) the M/F-ratio was 1.0 (0.4;2.3). In prepubertal ARDS patients with sepsis an increased frequency of male patients is found, comparable to adults. No male preponderance exists in patients with ARDS due to meningococcal septic shock. Since levels of testosterone and other sex hormones are extremely low at this age, we conclude that factors others than testosterone are involved in the male preponderance in severe sepsis.
UR - http://www.scopus.com/inward/record.url?scp=10744228182&partnerID=8YFLogxK
U2 - 10.1007/s00134-003-1948-z
DO - 10.1007/s00134-003-1948-z
M3 - Journal articles
C2 - 12920510
AN - SCOPUS:10744228182
SN - 0342-4642
VL - 29
SP - 1770
EP - 1773
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 10
ER -
