Sex-related mortality differences in septic shock: A propensity score–matched study

Purpose This study aimed to evaluate sex-specific differences in 28-day mortality among young adults (18–55 years) with septic shock using a large propensity score–matched cohort. Materials and methods We performed a retrospective propensity score–matched analysis using the TriNetX network. Adults 18–55 years old developing septic shock between January 2011 and January 2020 were identified. Women were matched 1:1 to men. The primary outcome was 28-day all-cause mortality; 90- and 180-day mortality were prespecified secondary outcomes. Results A total of 100,894 young adults (≥18 and ≤ 55 years) with septic shock were analyzed. After 1:1 propensity score matching, 86,748 patients (43,374 males and 43,374 females) were included in the analyses. The 28-day mortality rate was lower in young women compared to men (6630/43,374 [15.3%] vs. 7192/43,374 [16.6%]; RR = 0.92, 95% CI 0.89–0.95, p < 0.001). Similar results were observed for 90-day and 180-day mortality. Conclusions Mortality in young women with septic shock was lower than in young men suggesting sex-related differences and warranting further studies to explore therapeutic implications.