Older men more likely than women to die after...( PITTSBURGH April 29 Differing biolo...)

PITTSBURGH, April 29 Differing biological response to infection between men and women may explain higher death rates among older men who are hospitalized with community-acquired pneumonia (CAP). The findings, published online in the Critical Care Medicine journal, may have important implications for understanding sex differences in life expectancy.

"Our study found that men with CAP were less likely to survive after an infection compared to women and this was not explained by differences in demographics, health behavior, chronic health conditions or quality of care," said Sachin Yende, M.D., assistant professor in the Department of Critical Care Medicine at the University of Pittsburgh School of Medicine and corresponding author of the study.

The researchers measured blood levels of inflammatory indicators, including tumor necrosis factor (TNF) and interleukins 6 and 10, coagulation indicators including Factor IX, and fibrinolysis indicators including D-dimer concentrations. They found patterns in these biomarkers that suggest men generate a stronger inflammatory and coagulation response and, perhaps, break up blood clots more quickly than women in response to infection. "These differences in inflammatory, coagulation and fibrinolysis biomarkers among men may explain the reduced short-term and long-term survival," said Dr. Yende.

Data were gathered from the multicenter Genetic and Inflammatory Markers of Sepsis (GenIMS) study. Participants were enrolled upon emergency department admission at 28 academic and community hospitals in Pennsylvania, Connecticut, Michigan and Tennessee from 2001 to 2003. The study included 2,320 subjects, with a mean age of 64.9 years, 1,136 of whom were men. The men were sicker on admission, more likely to be smokers, and had at least one chronic health condition, such as cardiac disease or cancer. Severe sepsis occurred in 588 (31 percent) subjects. Of these, about half had severe sepsis on the
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