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Women receive less care in Canadian ICUs

Jill

There’s a disturbing disparity in death rates between critically ill men and women:

Older women with heart failure and other critical conditions receive less life support and die more than men in intensive care units, according to a disturbing new Canadian study.

This difference was most pronounced among women over age 50, who were 32% less likely than men to be admitted to intensive care units. They were also nine per cent less likely than men to receive mechanical ventilation to assist breathing and 20% less likely to receive pulmonary artery catheters to monitor failing hearts. They were also more likely to die.

“Among older patients, being female was associated with a 20% increased risk of death in ICU, an eight per cent increased risk of death in hospital and six per cent increased risk of death over one year,” reports a medical team that looked at almost 500,000 patients admitted to 13 Ontario hospitals over two years.

It’s another example of how traditional gender roles have very real effects on women’s lives:

He suspects some of the disparities may be rooted in the way men and women are viewed differently as they age in terms of using aggressive measures to treat failing lungs and hearts.

He says health care teams and family members frequently describe older female patients as “frail elderly women.”

“You don’t hear ‘frail’ and ‘man’ in the same sentence nearly as much,” says Dr. Fowler. Fathers and grandfathers, he says, are more likely to be viewed as “fighters” who would want aggressive care.

Women are also presumed to be weaker, and so their pain isn’t taken as seriously. A whole slew of other gender stereotypes and biases play into these kinds of disparities in care, and the situation certainly isn’t confined to Canada.

Thanks to Katy for the link.

6 thoughts on Women receive less care in Canadian ICUs

  1. My great-grandmother worked in a bomber plant during WWII, outlived both of her husbands, drove until she was blind (and still drove afterwards), and dipped snuff until she died at 95. Frail she was not. This sort of stuff breaks my heart.

  2. i also have to wonder how much is the fact that most studies of medicines and treatments are done primarily on men and may just not work quite as well in females.

  3. My grandfathers are the frailest elderly people I know. My one surviving grandmother, who’s still healthy and vigourous (the other one drank herself to death 🙁 ), kicks bottom and takes names.

    This study just confirms what a lot of Canadians know already — if someone goes into the hospital, someone healthy and responsible should be with them as much as possible to advocate for them. (This isn’t actually bad advice for anyone, anywhere, I might add.)

  4. Treating end of life aggressively may not be the most desirable option. Assuming that women who are undertreated in the ICU are being mistreated may be wrong. Women may have more end of life directives or greater wisdom about not prolonging their lives artificially. There is no mention of equating ages in this study. If women are entering the ICUs older, then it may be more appropriate for them to eschew extreme measures.

  6. “Wait a minute: what about the part where men die four years earlier than women?”

    Assuming a fairly normal percentage of men wind up in the hospital before dying rather than exploding in a tragically beautiful extreme off-road dirt-bike stunt gone awry, just like they always wanted, that just means the disparity should shrink as the women age, rather than increasing. That’s not what the study found–“a marked gender difference in critical care…became more pronounced the older the patients got, with men in their 60s, 70s and 80s far outnumbering older women in ICU.”

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