ICU sedation, delirium & recovery
Sex differences in advance directives and their clinical translation among critically ill adults: results from the ADVISE study
Authors' conclusion
This study revealed sex disparities in the content and translation of ADs between females and males admitted to ICUs. Females' ADs were more frequently violated, indicating a potential sex bias in the interpretation and translation of ADs in critical care.
Study context
- Population
- Critically ill adults treated >48 h in two interdisciplinary tertiary Swiss intensive care units (ICUs)313 with advance directives (ADs)
- Participants
- 5,242 adults
- Exposure
- Females vs males with ADs
- Femalesn = 1,813
- Malesn = 3,429reference
- Outcome
- Frequency of ADs
Methodological detailstwo-centre, tertiary ICUs
- Two-centre
- Tertiary ICUs
Main finding
As reported in the abstract
P = 0.054
- Overall ADs
- 313 (6.0%)
Observational data: associations, not effects.
Secondary outcomes
Single, divorced, or widowed (patients with ADs)
P = 0.001
Acute stroke as main diagnosis (patients with ADs)
P = 0.001
Refusal of CPR in ADs
P = 0.002
AD violated
P < 0.001
AD violation by unwanted treatments
P < 0.001
AD violation by undesired ICU admission
P = 0.002
Refusal of cardiopulmonary resuscitation (CPR) in ADs
- In multivariable analyses, female sex associated with refusing CPR independent of relationship status
Treatment adaptations in ICU, in-hospital outcomes, discharge destinations
- Did not differ between sexes
Original publication
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