Systematic Review of Gender Differences in Sepsis Management and Outcomes

Abstract

Purpose: Contributors to disparities in sepsis management have been attributed to genetic susceptibility, differences in clinical presentation, and healthcare delivery. The influence of gender on survival or mortality of patients with sepsis-related diagnoses is unclear. The purpose of the current study was to systematically review published research to identify factors and outcomes associated with sepsis management and outcomes based on gender differences.

Methods: Covering a period from 2006 to 2016, a literature search was conducted on four electronic data bases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCO, MedlinePlus, and PubMed. Content analysis of each article was performed independently by two authors. The guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was the method used to assess the quality of evidence of the articles in this review.

Findings: A full review was completed on a total of 452 identified potentially relevant publications, and 7 publications met inclusion criteria. The methodological approaches included prospective and retrospective observational studies, and prospective and historical cohort studies. The aim of these studies was to identify if gender differences exist related to sepsis-related mortality, completion of Surviving Sepsis Campaign resuscitation bundle elements, sepsis-related care processes, and sepsis-related incidence and source.

Conclusions: Clinical sepsis studies evaluating gender and sepsis-related management and mortality are inconclusive and complex. Three different outcomes exist: no difference, higher risk in females, or higher risk in males. Further studies are needed to support the presence of gender disparities on sepsis-related healthcare outcomes.

Clinical relevance: Providers should understand the importance of adhering to sepsis protocols and minimizing treatment disparities including gender differences.

Keywords: Gender; Surviving Sepsis Campaign; sepsis; sepsis bundle; sepsis management.