Gender differences in healthcare providers’ perceptions of key care priorities for very old patients in intensive care: a secondary analysis of results from ESICM recommendations for the management of very old patients

Background

Consensus-based recommendations have recently been developed to guide the delivery of quality care for very old patients (age ≥80 years) in the intensive care unit (ICU). To examine the influence of healthcare provider gender on agreement with consensus-based recommendations for the management of very old patients in ICUs.

Methods

Exploratory secondary analysis of survey responses from an international multiprofessional Delphi consensus on management of very old patients in ICUs by the European Society of Intensive Care Medicine. The primary analysis compared mean agreement scores between female and male participants using independent-samples t-tests. Secondary analyses included comparisons of strong agreement proportions and adjusted analyses using two-way analysis of variance and multivariable regression models including provider category and age.

Results

The analysis included 128 participants with available gender and clinical activity data (53 female and 75 male respondents). Female participants reported significantly higher agreement scores for several recommendations involving multidisciplinary input, including medication review, clinical pharmacist involvement, transfer to geriatric wards, dietitian support, and speech and language therapy (mean differences of approximately 7.4–11.0 points on a 0–100 scale, P <0.050). In contrast, male participants reported higher agreement for decisions to limit life-sustaining therapy based on expected functional outcome. Analysis of response proportions showed similar patterns, with females more frequently expressing strong agreement. In adjusted analyses, gender– provider specialty interactions were largely non-significant, indicating consistent effects across intensive care, emergency medicine, and geriatric medicine, except for medication review statements where a significant interaction (P=0.021) suggested variability across specialties.

Conclusions

In this exploratory secondary analysis, participant gender was associated with differences in agreement with selected consensus-based recommendations for the management of very old patients in ICUs, particularly those involving multidisciplinary team input. These findings highlight differences in perspectives toward specific recommendations within this international expert panel.