Association of sex with the clinical course and outcome of internal emergency department patients: a secondary data analysis

Eur J Emerg Med. 2021 Aug 1;28(4):299-305. doi: 10.1097/MEJ.0000000000000793.

Abstract

Background and importance: Differences between men and women visiting the emergency department (ED) with nonsurgical complaints have mostly been investigated in small, diagnosis-based subpopulations.

Objective: This study investigated sex-differences in an unselected cohort of nonsurgical ED patients.

Design: Secondary data of all patients attending two EDs of the Charité, Universitätsmedizin Berlin collected in the framework of their medical evaluation was reviewed.

Settings and participants: Within a 1-year-period all 34 333 adult internal patients presenting to one of the two EDs were included and analysed.

Outcomes measure and analyses: Sex-stratified descriptive analysis of the in-hospital course and outcome of the ED patients was performed as primary endpoint. Admission data, ED processes and diagnoses were analyzed as secondary endpoints.

Main results: A total of 51.2% of all patients were women. Women were slightly younger (median 56 years vs. men 58 years; P < 0.001) and presented more frequently with abdominal pain and headache. Men rather showed chest pain and dyspnea. Accordingly, women had more gastroenterological diseases; men were more often diagnosed with cardiological and pneumological diseases. Women were less frequently admitted for inpatient treatment [35.3 vs. men 43.7%; difference 8.4 percentage points (95% confidence interval (CI), 7.3-9.4)] and intensive care treatment [5.8 vs. men 9.0%; difference 3.2 percentage points (95% CI, 2.7-3.8)]. Inpatient-mortality did not show significant sex differences [4.6 women vs. 4.8% men; difference 0.2 percentage points (95% CI, -0.6 to 0.8)].

Conclusions: There are significant differences in characteristics, symptoms, diagnoses and clinical course between men and women. Further investigations could identify causes and measures like sex-specific algorithms for ED-work processes.

MeSH terms

  • Adult
  • Chest Pain
  • Data Analysis*
  • Emergency Service, Hospital*
  • Female
  • Hospitalization
  • Humans
  • Male
  • Sex Factors