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The following is a summary of “Sex difference in the risk of extubation failure in ICUs,” published in the December 2023 issue of Critical Care by Thille et al.

Despite rising ICU admissions, sex-based distinctions in outcomes for mechanically ventilated patients remain understudied. Researchers conducted a retrospective study to investigate a potential sex-based difference in extubation failure risk among ICU patients.

They conducted a post hoc analysis of a large-scale clinical trial that included patients at high risk of extubation failure in ICUs. The aim was to assess the risk of extubation failure based on sex. The primary outcome was reintubation within the 7 days following extubation.

The results showed 641 patients, 425 (66%) were males, and 216 (34%) were females. Males, more often admitted for cardiac arrest with underlying ischemic heart disease, contrasted with females, who were more likely admitted for coma with obesity. The reintubation rate at 48 hours was significantly higher in males compared to females (11.0% vs. 6.0%; difference, + 5.0 [95% CI, 0.2 to 9.2]; P=0.038). However, the reintubation rate 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). According to multivariable logistic regression analysis, male sex was independently associated with reintubation within 7 days following extubation (aOR 1.70 [95% CI, 1.01 to 2.89]; P=0.048), even after adjusting for the reason for admission, body-mass index, severity score, respiratory rate before extubation, and noninvasive ventilation after extubation.

They concluded that sex independently influenced reintubation risk in high-risk ICU patients, highlighting the need for further research on sex-specific outcomes in critical care.

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01225-7