SynthesisBMJ open2021
Sex as a prognostic factor for mortality in critically ill adults with sepsis: a systematic review and meta-analysis.
Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sex as a prognostic factor for mortality in adults with acute symptomatic pulmonary embolism.The Cochrane database of systematic reviews · 2025Pooled it
- Sex-Related Differences in Clinical Characteristics and Outcomes Among Patients Clinically Managed for Suspected Bacterial Infection in the Emergency Department.Medicina (Kaunas, Lithuania) · 2026Observational
- Targeting the NR1D1-IGF2BP2-V-ATPase Axis With Hybrid Nanovesicles Restores Macrophage Rhythms to Reverse Sepsis-Induced Immunosuppression.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Trajectories of sepsis survivors in Australia: A scoping review.Journal of the Intensive Care Society · 2026Article
- Age- and Sex-Related Outcomes in Patients with Sepsis or Septic Shock: A Prospective Monocentric Cohort Study.Journal of clinical medicine · 2026Article
- Impact of prenatal LPS on sepsis-related neurobiological outcomes.Metabolic brain disease · 2026Article
- Unveiling the role of sex as a predictor for KPC-Klebsiella pneumoniae and carbapenem-resistant Acinetobacter baumannii bacteremia in critically Ill colonized patients.BMC infectious diseases · 2026Article
- Association of lactate dehydrogenase to albumin ratio with new-onset acute respiratory distress syndrome and all-cause mortality in patients with sepsis: a retrospective cohort study based on the MIMIC-IV database.BMC infectious diseases · 2026Article
- Sepsis in the Emergency Department: Different Faces, Same Fate? A Sex-Based Prognostic Analysis.International journal of molecular sciences · 2026Article
- Do Obesity Classifications Create the Obesity Paradox? A Scoping Review of Obesity Definitions Applied in Sepsis Research.Clinical obesity · 2026Article
- Completion of the 1-Hour Sepsis Bundle on 90-Day Mortality in Adult Patients With Sepsis.Journal of the American College of Emergency Physicians open · 2026Article
- Sex and gender differences in hemostasis in critical illness.Critical care science · 2026Review
- Nationwide trends and disparities in deaths following cardiogenic shock and sepsis in the United States (1999-2023): insights from the CDC WONDER database.BMC cardiovascular disorders · 2025Article
- Sex differences in sepsis outcomes across the lifespan: a population-based cohort study in Germany.Critical care (London, England) · 2025Article
- Evaluating the obesity paradox in patients with sepsis and cancer.International journal of obesity (2005) · 2025Article
- Temporal impact of sepsis on Alzheimer's disease pathology and neuroinflammation.Progress in neurobiology · 2025Article
- SEX DIFFERENCES IN SEPSIS-RELATED ACUTE RESPIRATORY DISTRESS SYNDROME AND OTHER SHORT-TERM OUTCOMES AMONG CRITICALLY ILL PATIENTS WITH SEPSIS: A RETROSPECTIVE STUDY IN CHINA.Shock (Augusta, Ga.) · 2025Observational
- Inflammatory burden index as a predictor of mortality in septic patients: a retrospective study using the MIMIC-IV database.BMC infectious diseases · 2025Article
- Sex specific differences in short-term mortality after ICU-delirium.Critical care (London, England) · 2024Article
- Sex matters: Is it time for a SOFA makeover?Critical care (London, England) · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the role of sex as an independent prognostic factor for mortality in patients with sepsis admitted to intensive care units (ICUs).
designSystematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, Web of Science, ClinicalTrials.gov and the WHO Clinical Trials Registry from inception to 17 July 2020. STUDY SELECTION: Studies evaluating independent associations between sex and mortality in critically ill adults with sepsis controlling for at least one of five core covariate domains prespecified following a literature search and consensus among experts. DATA EXTRACTION AND SYNTHESIS: Two authors independently extracted and assessed the risk of bias using Quality In Prognosis Studies tool. Meta-analysis was performed by pooling adjusted estimates. The Grades of Recommendations, Assessment, Development and Evaluation approach was used to rate the certainty of evidence.
resultsFrom 14 304 records, 13 studies (80 520 participants) were included. Meta-analysis did not find sex-based differences in all-cause hospital mortality (OR 1.02, 95% CI 0.79 to 1.32; very low-certainty evidence) and all-cause ICU mortality (OR 1.19, 95% CI 0.79 to 1.78; very low-certainty evidence). However, females presented higher 28-day all-cause mortality (OR 1.18, 95% CI 1.05 to 1.32; very low-certainty evidence) and lower 1-year all-cause mortality (OR 0.83, 95% CI 0.68 to 0.98; low-certainty evidence). There was a moderate risk of bias in the domain adjustment for other prognostic factors in six studies, and the certainty of evidence was further affected by inconsistency and imprecision.
conclusionThe prognostic independent effect of sex on all-cause hospital mortality, 28-day all-cause mortality and all-cause ICU mortality for critically ill adults with sepsis was uncertain. Female sex may be associated with decreased 1-year all-cause mortality. PROSPERO REGISTRATION NUMBER: CRD42019145054.
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