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Open Access 01-12-2023 | Research

Sex difference in the risk of extubation failure in ICUs

Authors: Arnaud W. Thille, Florence Boissier, Rémi Coudroy, Sylvain Le Pape, François Arrivé, Laura Marchasson, Jean-Pierre Frat, Stéphanie Ragot, for the REVA Research Network

Published in: Annals of Intensive Care | Issue 1/2023

Abstract

Background

Little attention has been paid to potential differences in prognosis between mechanically ventilated males and females in intensive care units (ICUs). We hypothesized that a sex gap in the risk of extubation failure in ICUs may exist.

Methods

Post hoc analysis of a large-scale clinical trial including patients at high risk of extubation failure in ICUs, with the aim of assessing the risk of extubation failure according to sex. The primary outcome was reintubation within the 7 days following extubation.

Results

Out of 641 patients, 425 (66%) were males and 216 (34%) were females. Males were more likely to be admitted for cardiac arrest and to have underlying ischemic heart disease whereas females were more likely to be admitted for coma and to have obesity. Whereas the rate of reintubation at 48 h was significantly higher in males than in females (11.0% vs. 6.0%; difference, + 5.0 [95% CI, 0.2 to 9.2]; P = 0.038), the rate of reintubation at day 7 did not significantly differ between males and females (16.7% vs. 11.1%; difference, + 5.6% [95%CI, − 0.3 to 10.8], P = 0.059). Using multivariable logistic regression analysis, male sex was independently associated with reintubation within the 7 days following extubation (adjusted OR 1.70 [95% CI, 1.01 to 2.89]; P = 0.048), even after adjustment on reason for admission, body-mass index, severity score, respiratory rate before extubation, and noninvasive ventilation after extubation.

Conclusion

In this post hoc analysis of a clinical trial including a homogeneous subset of patients at high risk of extubation failure, sex was independently associated with reintubation. The role of sex on outcomes should be systematically examined in future studies of critically ill patients.

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Title: Sex difference in the risk of extubation failure in ICUs
Authors: Arnaud W. Thille
Florence Boissier
Rémi Coudroy
Sylvain Le Pape
François Arrivé
Laura Marchasson
Jean-Pierre Frat
Stéphanie Ragot
for the REVA Research Network
Publication date: 01-12-2023
Publisher: Springer International Publishing
Published in: Annals of Intensive Care / Issue 1/2023
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/s13613-023-01225-7

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Springer Medicine

Sex difference in the risk of extubation failure in ICUs

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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