We read with great interest the recent article by Schröder et al1 titled "Gender Differences in Human Sepsis." It is a well-designed study carried out in a homogeneous group of patients with abdominal sepsis. However, we would like to suggest 2 considerations to this study.
First, these authors conclude that women have a lower mortality rate than men. Several large cohort studies carried out in patients with sepsis analyzed sex as a risk factor for mortality, and this conclusion was not obtained.2 Although both groups had similar Acute Physiology and Chronic Health Evaluation II scores and multiple organ dysfunction scores at admission to the study and the causes of sepsis were well distributed between the groups, several comorbidities or confounding variables not analyzed could not be similar in both groups, and it might explain this conclusion.
Montero JG, Ortiz-Leyba C, Jiménez-Jiménez J, García-Garmendia JL. Interleukin 10 and Sepsis. Arch Surg. 2000;135(7):875-876. doi: