Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency Department
Objectives: Sepsis is a common presentation to the emergency department (ED) and represents a life-threatening syndrome with high mortality rates. The existing literature has conflicting findings regarding outcomes between sexes. Our goal in this study was to investigate the clinical presentation, i...
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eScholarship Publishing, University of California
2025-07-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/5xq2x1q7 |
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| author | Joseph O’Brien Jon W. Schrock |
| author_facet | Joseph O’Brien Jon W. Schrock |
| author_sort | Joseph O’Brien |
| collection | DOAJ |
| description | Objectives: Sepsis is a common presentation to the emergency department (ED) and represents a life-threatening syndrome with high mortality rates. The existing literature has conflicting findings regarding outcomes between sexes. Our goal in this study was to investigate the clinical presentation, interventions, and outcomes based on sex for sepsis in the ED. Methods: We conducted a retrospective cohort study to identify patients presenting with sepsis to the ED. We employed the Global Collaborative Network from 119 international healthcare organizations in the TriNetX Research Network. Sepsis was defined according to International Classification of Diseases, 10 th Rev, codes. To evaluate sex differences in sepsis presentation, we collected data on age, comorbidities, sex, vital signs, laboratory values, medications, intensive care unit (ICU) admission, mechanical ventilation, and mortality at 30 days, 90 days, and one year. We used a 1:1 propensity score matching by age, race, comorbidities, and infection source to identify and balance potential risk factors across the study groups to investigate mortality, interventions, and intensive care unit admission trends. Data abstraction and analysis were conducted in the TriNetX platform. Results: In total, 920,160 patients were included in this study. The most common infection source for both females and males was respiratory, accounting for 40% and 46.2% of sepsis cases, respectively. After adjusting for urinary tract infection as an infection source, females were less likely to receive piperacillin-tazobactam (21% vs 23.6%; odds ratio [OR] 0.76; 95% confidence interval [CI] 0.75 – 0.77), vancomycin (32.9% vs 36%; OR, 0.87; 95% CI 0.86 – 0.88), and vasopressors (16.5% vs 17.6%; OR, 0.92; 95% CI 0.91 – 0.93). Females had a lower all-cause mortality at 30 days (12.1% vs 13%; OR 0.91; 95% CI 0.90 – 0.92), 90 days (17.1% vs 18.7%; OR 0.91; 95% CI 0.90 – 0.92), and one year (21.5% vs 23.3%; OR 0.90; 95% CI 0.89 – 0.91). Conclusion: Females demonstrated 10% lower odds of mortality from sepsis at 30 days, 90 days, and one year (absolute difference: 0.9%, 1.6%, 1.8%, respectively). Females were less likely to receive vasopressors, vancomycin, or piperacillin-tazobactam, even after accounting for urinary tract infection as the sepsis source. |
| format | Article |
| id | doaj-art-d56eb3567dcd4439be266a2b3a0d87b3 |
| institution | Kabale University |
| issn | 1936-900X 1936-9018 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj-art-d56eb3567dcd4439be266a2b3a0d87b32025-08-20T03:41:47ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182025-07-0126488088710.5811/westjem.40005wjem-26-880Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency DepartmentJoseph O’Brien0Jon W. Schrock1Cleveland Clinic Lerner College of Medicine, Department of Emergency Medicine, Cleveland, OhioMetroHealth Medical Center, Department of Emergency Medicine, Cleveland, OhioObjectives: Sepsis is a common presentation to the emergency department (ED) and represents a life-threatening syndrome with high mortality rates. The existing literature has conflicting findings regarding outcomes between sexes. Our goal in this study was to investigate the clinical presentation, interventions, and outcomes based on sex for sepsis in the ED. Methods: We conducted a retrospective cohort study to identify patients presenting with sepsis to the ED. We employed the Global Collaborative Network from 119 international healthcare organizations in the TriNetX Research Network. Sepsis was defined according to International Classification of Diseases, 10 th Rev, codes. To evaluate sex differences in sepsis presentation, we collected data on age, comorbidities, sex, vital signs, laboratory values, medications, intensive care unit (ICU) admission, mechanical ventilation, and mortality at 30 days, 90 days, and one year. We used a 1:1 propensity score matching by age, race, comorbidities, and infection source to identify and balance potential risk factors across the study groups to investigate mortality, interventions, and intensive care unit admission trends. Data abstraction and analysis were conducted in the TriNetX platform. Results: In total, 920,160 patients were included in this study. The most common infection source for both females and males was respiratory, accounting for 40% and 46.2% of sepsis cases, respectively. After adjusting for urinary tract infection as an infection source, females were less likely to receive piperacillin-tazobactam (21% vs 23.6%; odds ratio [OR] 0.76; 95% confidence interval [CI] 0.75 – 0.77), vancomycin (32.9% vs 36%; OR, 0.87; 95% CI 0.86 – 0.88), and vasopressors (16.5% vs 17.6%; OR, 0.92; 95% CI 0.91 – 0.93). Females had a lower all-cause mortality at 30 days (12.1% vs 13%; OR 0.91; 95% CI 0.90 – 0.92), 90 days (17.1% vs 18.7%; OR 0.91; 95% CI 0.90 – 0.92), and one year (21.5% vs 23.3%; OR 0.90; 95% CI 0.89 – 0.91). Conclusion: Females demonstrated 10% lower odds of mortality from sepsis at 30 days, 90 days, and one year (absolute difference: 0.9%, 1.6%, 1.8%, respectively). Females were less likely to receive vasopressors, vancomycin, or piperacillin-tazobactam, even after accounting for urinary tract infection as the sepsis source.https://escholarship.org/uc/item/5xq2x1q7 |
| spellingShingle | Joseph O’Brien Jon W. Schrock Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency Department Western Journal of Emergency Medicine |
| title | Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency Department |
| title_full | Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency Department |
| title_fullStr | Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency Department |
| title_full_unstemmed | Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency Department |
| title_short | Sepsis Presentation, Interventions, and Outcome Differences Among Men and Women in the Emergency Department |
| title_sort | sepsis presentation interventions and outcome differences among men and women in the emergency department |
| url | https://escholarship.org/uc/item/5xq2x1q7 |
| work_keys_str_mv | AT josephobrien sepsispresentationinterventionsandoutcomedifferencesamongmenandwomenintheemergencydepartment AT jonwschrock sepsispresentationinterventionsandoutcomedifferencesamongmenandwomenintheemergencydepartment |