Author Of 1 Presentation
GENDER DIFFERENCES IN INFANT MORTALITY IN UK PAEDIATRIC INTENSIVE CARE UNITS LONG TERM OUTCOME
Abstract
Background
Most children who die in UK Paediatric Intensive Care Units (PICUs) are infants. Male infants have higher mortality compared to female infants globally. Specific reasons that drive the UK gender disparity have not been studied.
Objectives
To study gender differences in UK PICU mortality and investigate factors that may explain these differences
Methods
We extracted data from UK PICUs from 01/2005 to 12/2015 and included all infants aged 0-12 months admitted to PICU. To investigate potential aetiological causes for differences in mortality, we used a parametric cause-specific hazard ratio (CSHR) with restricted cubic splines, time varying coefficients, and cluster robust standard errors. Variables used for risk adjustment were a recalibrated version of PIM2, age at admission, elective or emergency admission, infection, year and month of admission, inotropic and renal support.
Results
We analysed records of 71,242 infants from 35 PICUs. More female than male infants died (1809/41723, 4.3% versus 1411/29519, 4.8% for males/females respectively). The adjusted CSHR for males versus females was 0.88 (95% CI 0.82 to 0.95, p=0.001). Higher PIM2 score, infection, inotropic and renal support were all strongly associated with an increased CSHR for mortality. Older age and later years were strongly associated with deccreased mortality. None of the factors investigated altered the CSHR. The CSHR of gender was at its lowest during the first three days of admission, suggesting that whatever drives higher female mortality occurs early after admission.
Conclusion
UK female infants have higher PICU mortality than male infants. The reason behind this finding is unclear and needs further investigation.