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<p>Sex differences in intensive care medicine, particularly regarding risk factors for (MV), are underexplored. This study aimed to investigate sex-related risk factors for long-term MV. We analyzed claims data from patients aged ≥ 30, with at least one comorbidity, who received MV (≥ 96 h) between 2015 and 2018. Data covered 365 days prior to hospitalization and 30 days post-discharge. Sex differences in 29 predefined risk factors were assessed. Over 12,000 hospitalizations were analyzed, with 37.8% of patients being female. Women were older (71.3 ± 11.6 vs. 69.9 ± 11.2 years, p &lt; 0.001) and more often transferred from nursing homes (4.5% vs. 2.7%, p &lt; 0.001). Men required invasive long-term ventilation more often (33.8% vs. 31.2%, p = 0.004) and had more ventilation hours (400.0 ± 377.9 vs. 373.0 ± 341.8, p &lt; 0.001). Among pre-existing conditions, women had more thyroiditis and rheumatic mitral valve disease, while men had more COPD, cardiac arrhythmia, eating disorders, and acute pancreatitis. Men were more likely to undergo bronchoscopy, autologous blood transfusion, or Extracorporeal life support (ECLS) within 96 h of MV. Multivariate analyses revealed stronger associations between certain risk factors and long-term MV by sex. For men, thyroiditis (OR 2.7 vs. 1.4 in women), cerebral infarction (OR 2.3 vs. 1.4), and acute pancreatitis (OR 3.2 vs. 1.0) were more strongly linked to weaning failure. For women, cerebrospinal fluid surgery (OR 5.7 vs. 2.0 in men) and acute pancreatitis (OR 4.7 vs. 3.0 in men) had stronger associations with long-term MV. ECLS and eating disorders were only linked to long-term MV in men. This study highlights sex differences in risk factors and outcomes for long-term MV, suggesting the need for sex-specific management strategies.</p><p><b>Trial registration:</b> The PRiVENT study was retrospectively registered at ClinicalTrials.gov (NCT05260853). Registered at March 2, 2022.</p>

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Sex-specific differences in risk factors and outcomes for long-term mechanical ventilation: a longitudinal cohort analysis of claims data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月8日

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  • Franziska C. Trudzinski,
  • Benjamin Neetz,
  • Jana Dahlhoff,
  • Philipp Höger,
  • Axel Kempa,
  • Claus Neurohr,
  • Armin Schneider,
  • Felix J. F. Herth,
  • Biljana Joves,
  • Joachim Szecsenyi,
  • Elena Biehler,
  • Thomas Fleischhauer,
  • Janina Schubert-Haack,
  • Thomas Grobe,
  • Timm Frerk,
  • Gabriele Iberl,
  • Julia Dorothea Michels-Zetsche,
  • Michael Müller,
  • Andreas Rheinhold,
  • Ahmed Ehab,
  • Alessandro Ghiani,
  • Nina Lutz,
  • Swenja Walcher,
  • Konstantinos Tsitouras,
  • Joanna Paderewska,
  • Selina Briese,
  • Christoph Rauch,
  • Patrick Gehrig,
  • Joachim Sugg,
  • Susanne Hirschmann,
  • Thomas Fleischhhauer,
  • Gerhard Fuchs,
  • Nicola Litke,
  • Markus Qreini,
  • Michel Wensing,
  • Anja Klingenberg,
  • Teresa Byczkowski,
  • Manuel Feißt,
  • Simone Britsch,
  • Christa Straub,
  • Claude Jabbour,
  • Michael Hahn,
  • Jörg Krebs,
  • Peter-Tobias Graf,
  • Petra Denzer,
  • Uta Merle,
  • Monica Boxberger,
  • Mascha Fiedler-Kalenka,
  • Guido Hundt,
  • Jens Regula,
  • Thushira Weerawarna,
  • Miriane Bomeken,
  • Lisa Amega,
  • Shumallah Basit,
  • Sebastian Stier,
  • Matthias Körner,
  • Jens Müller,
  • Sergej Markin,
  • Ute Oltmanns,
  • Oliver Gorgs,
  • Mark Hackbarth,
  • Sebastian Münz,
  • Dominik Scharpf,
  • Thomas J. Dengler,
  • Mathias Borst,
  • Brigitte Mayer,
  • Wolfgang Reikow,
  • Markus Kredel,
  • Patrick Keppeler,
  • Konstantin Frey,
  • Holger Wolff,
  • Florian Seidlitz,
  • Stefanie Bientzle,
  • Boris Nohé,
  • Sebastian Allgäuer,
  • Alexej Schöpp,
  • Jörg Winckelmann,
  • Christoph Schlegel,
  • Imke Hübner,
  • Andrzej Kuzniar,
  • Helene Häberle,
  • Reimer Riessen,
  • Benjamin Schempf,
  • Ingo Rebenschütz,
  • Andreas Straub,
  • Marc Kollum,
  • Markus Winter,
  • Paul Hartveg,
  • Andreas Junginger,
  • Thomas Abt,
  • Mathias Vogel,
  • Ralf Völker,
  • Thomas Wiesmann

摘要

Sex differences in intensive care medicine, particularly regarding risk factors for (MV), are underexplored. This study aimed to investigate sex-related risk factors for long-term MV. We analyzed claims data from patients aged ≥ 30, with at least one comorbidity, who received MV (≥ 96 h) between 2015 and 2018. Data covered 365 days prior to hospitalization and 30 days post-discharge. Sex differences in 29 predefined risk factors were assessed. Over 12,000 hospitalizations were analyzed, with 37.8% of patients being female. Women were older (71.3 ± 11.6 vs. 69.9 ± 11.2 years, p < 0.001) and more often transferred from nursing homes (4.5% vs. 2.7%, p < 0.001). Men required invasive long-term ventilation more often (33.8% vs. 31.2%, p = 0.004) and had more ventilation hours (400.0 ± 377.9 vs. 373.0 ± 341.8, p < 0.001). Among pre-existing conditions, women had more thyroiditis and rheumatic mitral valve disease, while men had more COPD, cardiac arrhythmia, eating disorders, and acute pancreatitis. Men were more likely to undergo bronchoscopy, autologous blood transfusion, or Extracorporeal life support (ECLS) within 96 h of MV. Multivariate analyses revealed stronger associations between certain risk factors and long-term MV by sex. For men, thyroiditis (OR 2.7 vs. 1.4 in women), cerebral infarction (OR 2.3 vs. 1.4), and acute pancreatitis (OR 3.2 vs. 1.0) were more strongly linked to weaning failure. For women, cerebrospinal fluid surgery (OR 5.7 vs. 2.0 in men) and acute pancreatitis (OR 4.7 vs. 3.0 in men) had stronger associations with long-term MV. ECLS and eating disorders were only linked to long-term MV in men. This study highlights sex differences in risk factors and outcomes for long-term MV, suggesting the need for sex-specific management strategies.

Trial registration: The PRiVENT study was retrospectively registered at ClinicalTrials.gov (NCT05260853). Registered at March 2, 2022.