ArticleBMC women's health2026
Clinical characteristics and outcomes of critically ill women with gynecologic malignancies: a two-database retrospective study using MIMIC-IV v3.1 and eICU-CRD v2.0.
Article in BMC women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWomen with gynecologic malignancies may require intensive care unit (ICU) admission for postoperative complications, infection, organ dysfunction, treatment-related toxicity, or advanced cancer. Multicohort ICU outcome data for this population are limited. We described characteristics and in-hospital outcomes using two public critical care databases.
methodsWe conducted a retrospective cohort study using MIMIC-IV v3.1 and eICU-CRD v2.0. Adult female ICU stays with gynecologic malignancy were identified by ICD codes in MIMIC-IV and diagnosis strings in eICU-CRD. The primary outcome was in-hospital mortality. The primary pooled model evaluated age, tumor group, database-recorded sepsis, database-recorded acute kidney injury, metastatic cancer, and database cohort. Additional sensitivity analyses incorporated first-day Sequential Organ Failure Assessment (SOFA) in MIMIC-IV, Acute Physiology and Chronic Health Evaluation (APACHE) IVa in eICU-CRD, first-24-hour organ support, laboratory-burden proxies, patient-level clustering, hospital/center-cluster robust standard errors, and database interaction terms.
resultsThe study included 711 ICU stays, including 248 from MIMIC-IV and 463 from eICU-CRD. Overall in-hospital mortality was 14.5%. In the primary pooled model, database-recorded sepsis (OR 2.17, 95% CI 1.35-3.49), database-recorded acute kidney injury (OR 2.27, 95% CI 1.38-3.71), and metastatic cancer (OR 2.03, 95% CI 1.14-3.59) were associated with higher in-hospital mortality. Severity scores were higher among nonsurvivors (median SOFA 6.0 vs. 3.0 in MIMIC-IV; median APACHE IVa 77.0 vs. 50.0 in eICU-CRD). In database-specific severity models, SOFA (OR 1.30 per point, 95% CI 1.14-1.49) and APACHE IVa (OR 1.04 per point, 95% CI 1.03-1.05) were strongly associated with mortality, while sepsis and acute kidney injury estimates attenuated.
conclusionsCritically ill women with gynecologic malignancies had substantial in-hospital mortality. Database-recorded sepsis, database-recorded acute kidney injury, and metastatic cancer identified higher-risk patients in the primary model, but severity-adjusted analyses suggest that these variables should be interpreted mainly as descriptive markers of acute illness burden rather than independent causal effects.
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