The DISPARITY Study

Do gender differences exist in Surviving Sepsis Campaign resuscitation bundle completion, completion of individual bundle elements, or sepsis mortality?

Tracy E. Madsen, James Simmons, Esther Choo, David Portelli, Alyson J. McGregor, Anthony M. Napoli

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: Women in the emergency department are less likely to receive early goal directed therapy, but gender differences in the Surviving Sepsis Campaign (SSC) bundle completion have not been studied [1]. We hypothesized that women have lower SSC resuscitation bundle completion rates. Materials and methods: This was a retrospective, observational study in a large urban academic ED at a national SSC site. Consecutive patients (age >. 18 years) admitted to intensive care with severe sepsis or septic shock and entered into the SSC database from October 2005 to February 2012 were included. Data on overall and individual bundle elements were exported from the database. Bivariate analyses were performed with chi-square tests and t-tests. Multiple logistic regression was then performed with gender as an effect modifier. Results: Eight hundred fourteen patients were enrolled. The mean age was 66 years;, 44.8% were women. There was no association between gender and bundle completion (aOR 0.83, 95% CI 0.58-1.16), controlling for age, race, Sequential Organ Failure Assessment, congestive heart failure, and coagulopathy. In-hospital mortality did not differ by gender. Women were less likely to receive antibiotics within 3 hours (60.5% vs. 68.8%, p = 0.01) and less likely to reach a target ScvO2 >70 (31.3% vs. 39.5%, P = .05). Conclusions: There were no gender disparities in bundle completion or in-hospital mortality. Further research is needed to examine individual bundle elements and gender specific factors that may affect bundle completion and mortality.

Original languageEnglish (US)
JournalJournal of Critical Care
Volume29
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Resuscitation
Sepsis
Mortality
Hospital Mortality
Databases
Chi-Square Distribution
Critical Care
Septic Shock
Observational Studies
Hospital Emergency Service
Heart Failure
Retrospective Studies
Logistic Models
Anti-Bacterial Agents
Research
Therapeutics

Keywords

  • Gender
  • Resuscitation bundle
  • Sepsis
  • Surviving Sepsis Campaign

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Medicine(all)

Cite this

The DISPARITY Study : Do gender differences exist in Surviving Sepsis Campaign resuscitation bundle completion, completion of individual bundle elements, or sepsis mortality? / Madsen, Tracy E.; Simmons, James; Choo, Esther; Portelli, David; McGregor, Alyson J.; Napoli, Anthony M.

In: Journal of Critical Care, Vol. 29, No. 3, 2014.

Research output: Contribution to journalArticle

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abstract = "Purpose: Women in the emergency department are less likely to receive early goal directed therapy, but gender differences in the Surviving Sepsis Campaign (SSC) bundle completion have not been studied [1]. We hypothesized that women have lower SSC resuscitation bundle completion rates. Materials and methods: This was a retrospective, observational study in a large urban academic ED at a national SSC site. Consecutive patients (age >. 18 years) admitted to intensive care with severe sepsis or septic shock and entered into the SSC database from October 2005 to February 2012 were included. Data on overall and individual bundle elements were exported from the database. Bivariate analyses were performed with chi-square tests and t-tests. Multiple logistic regression was then performed with gender as an effect modifier. Results: Eight hundred fourteen patients were enrolled. The mean age was 66 years;, 44.8{\%} were women. There was no association between gender and bundle completion (aOR 0.83, 95{\%} CI 0.58-1.16), controlling for age, race, Sequential Organ Failure Assessment, congestive heart failure, and coagulopathy. In-hospital mortality did not differ by gender. Women were less likely to receive antibiotics within 3 hours (60.5{\%} vs. 68.8{\%}, p = 0.01) and less likely to reach a target ScvO2 >70 (31.3{\%} vs. 39.5{\%}, P = .05). Conclusions: There were no gender disparities in bundle completion or in-hospital mortality. Further research is needed to examine individual bundle elements and gender specific factors that may affect bundle completion and mortality.",
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