Table 2 .
Sex-disaggregated data on CAP incidence and severity
| Study | Study type and years of data | Country | Number of patients | Incidence rates by sex | Outcomes by sex |
|---|---|---|---|---|---|
| Restrepo et al. [119] | Retrospective, 1999–2001 | USA | 730 patients with CAP | Not reported | Patients were more likely males in ICU (88%) than ward (75%) (p = 0.001) |
| Reade et al. [54] | Prospective, 2001–2003 | USA | 2.183 patients with CAP | Not reported |
Men had a higher ICU admission rate (4.4% vs 2.2%, p = 0.001) and a higher risk of death at 30-days (7% vs. 4.5%, p = 0.01), 90-days (11.4% vs. 8.6%, p = 0.02) and one year (21% vs. 16%, p = 0.002) Adjusted HR for 1-year mortality = 1.29, (95% CI = 1.05–1.59; p = 0.04) |
| Millet et al. [12] | Retrospective, 1997–2011 | United Kingdom | 65.000 CAP cases from more than 1,5 million patients, all ≥ 65 years old | M: F = 56: 44. Incidence rate: 8.60 (M) vs 7.53 (F) /1000 person-years; after standardizing for age: 8.31–11.09 (M) vs 5.56–7.65 (F) /1000 person-years | Not reported |
| Arnold et al. [120] | Secondary analysis of clinical trial, 2001–2011 | 17 countries | 6.718 patients with CAP | M: F = 60: 40 |
Adjusted HR for time to clinical stability = 0.91 (95% CI 0.85–0.97; p = 0.05) Adjusted HR for length of stay = 0.94 (95% CI 0.88–1.01; p = 0.089) Adjusted RR for in-hospital mortality = 1.04 (95% CI 0.86–1.24; p = 0.717) Adjusted RR for 28-day mortality = 1.15 (95% CI 1.02–1.30; p = 0.018) |
| Kolditz et al. [121] | Prospective, 2007–2013 | Germany | 3.427 patients with CAP | Not reported | No sex-related difference in developing of “emergency CAP” |
| Rivero-Calle et al. [13] | Retrospective, 2009–2013 | Spain | 28.400 CAP cases from 2,3 million patients | Incidence rate: 5.04 (M) vs 4.26 (F) /1000 person-years. In 18–65 years old: 2.18–5.75 (M) vs 1.47–5.21 (F) /1000 person-years. In > 65 years old: 7.06–36.39 (M) vs 5.43–19.62 (F) | Not reported |
| Gonzalez Quero et al. [122] | Prospective, 2012–2016 | Spain | 1389 patients with CAP | M: F = 64: 36 | IHM = 3% in both groups |
| Corrado et al. [123] | Retrospective, 2010–2014 | USA | 154.000 patients with CAP | Mean annual age-adjusted hospitalization rates for CAP: 552.6 (M) vs 429.2 (F) /100.000 population/year. RR for male sex = 1.3 (95% CI 1.3–1.3) | Not reported |
| de Miguel-Diez et al. [86] | Retrospective, 2004–2013 | Spain | 960.000 admissions for CAP | M: F = 61: 39. Incidence was higher in males in all age groups | Female sex is a risk factor for IHM: OR = 1.05 (95% CI 1.04–1.06) |
| Alsawas et al. [82] | Retrospective, 1995–2015 | USA | 13.000 cases of pneumonia | M: F = 55: 45 | Men had a higher 30-days mortality: adjusted OR = 1.19 (95% CI = 1.06–1.34) |
| Fassmer et al. [124] | Retrospectiv, 2010–2014 | Germany | 19.200 cases of pneumonia from 127.000 nursing homes’ patients, all ≥ 65 years old | Incidence rate: 20.9 (M) vs 9.6 (F) /100 person-years. HR for male sex = 1.88 (1.83–1.94) | Not reported |
| Pessoa et al. [83] | Retrospectiv, 2000–2014 | Portugal | 549.000 hospitalizations due to CAP | M: F = 55: 45 | Male sex is a risk factor for IHM: adjusted OR = 1.261 (95%CI 1.243–1.280) |
| Peyrani et al. [87] | Secondary data analysis, 2014–2016 | USA | 7.449 patients with CAP | Not reported | No sex-related difference was found in groups with clinical improvement, clinical failure or non-resolving pneumonia |
| Sun et al. [14] | Retrospectiv, 2016 | China | 1.48 million CAP episodes from 427 million patients | Incidence rate: 7.32 (M) vs 6.93 (F) /1000 person-years; after standardizing for age: 9.52 (M) vs 8.54 (F) /1000 person-years | Not reported |
| de Miguel-Yanes et al. [16] | Retrospectiv, 2016–2019 | Spain | 519.000 patients with CAP | M: F = 59: 41. Incidence rate: 429.59 (M) vs 283.3 (F) /100.000 inhabitants. Incidence rate ratio (IRR) = 1.47 (95% CI 1.45–1.50) | IHM: 12.5% (M) vs. 12.2% (F) before PSM, and 12.9% (M) vs. 12.2% (F) after PSM (= a 5.7% higher relative risk among men). Male sex was a risk factor for IHM: OR = 1.13 (95% CI 1.10–1.15) |
Studies are ordered according to publication year. Where not otherwise specified, patients’ number indicates the total studied population, not the number of CAP cases
CAP community-acquired pneumonia, ICU intensive care unit, HR hazard ratio, OR odds ratio, RR risk ratio, IHM in-hospital mortality, PSM propensity score matching, 95% CI 95% confidence interval