Women in Indian ICUs get fewer life-saving measures than men, finds US study

Chennai: Women admitted to intensive care units (ICU) across India receive significantly less aggressive interventions than men—including life support from ventilators, dialysis and cardiovascular drugs—yet their rate of survival is nearly identical, according to a landmark study published in the peer-reviewed US journal Critical Care Medicine. The research has left intensive care specialists wondering, are women being under-treated, or are men being over-treated?The findings, drawn from more than 82,000 patients across 45 ICUs in 26 hospitals—public and private—over nearly six years, raise questions about whether sex and cultural bias is quietly shaping treatment decisions in Indian hospitals. Women were 22% less likely than men to receive invasive mechanical ventilation—which most critically ill patients depend on—and 27% less likely to receive kidney replacement therapy. They were also less likely to be given vasopressors, the drugs used to stabilize dangerously low blood pressure. One exception cut the other way—women were more likely to receive non-invasive ventilation, a gentler form of breathing support. "We don't yet know if it's good or bad," said Dr Bharath Kumar Tirupakuzhi Vijayaraghavan, lead author of the study and critical care specialist at Apollo Hospitals, Chennai.Yet, despite receiving less of nearly every critical intervention, women died in the ICU at a rate of 9.5%—barely different from the 10.3% recorded for men. Researchers feel doctors may be misjudging how ill women are—underestimating severity, or maybe overestimating it in men. Family members, shaped by deeply entrenched social norms, may also be making treatment decisions for women that they would not make for men. "In a country where women routinely face barriers to healthcare access, those biases do not simply disappear at the ICU door," said Dr Sristi Sharma, co-author of the study.Dr Vijayaraghavan said, "In critical care, more is not always better. Putting a patient on an invasive ventilator carries risks—lung injury, infections, complications. If such support doesn't precisely match what a patient's body needs, it can do more harm than good."So, are women being under-treated or are men overtreated? The authors agree that more study is needed. "We also need to ask whether women and men have equal access to preventive and early care," Dr Vijayaraghavan added.The authors further clarified that the majority of patients studied were treated in private facilities in large urban centres. The picture in rural hospitals—where gender discrimination in healthcare is often starker—remains largely unmapped.