There are noticeable disparities between men and women regarding illness frequency, clinical presentation, treatment response, and prognosis. However, with the very ill, such information is rare. The efficacy of clinical therapy and outcomes for patients presenting with acute dyspnea, the most common reason for emergency department (ED) admission, depend on clinicians’ understanding of distinctions associated with biological sex. For a study, researchers sought to evaluate the impact of biological sex on 1-year all-cause mortality in patients who presented to the emergency department with acute dyspnea.

Two EDs in Lithuania received consecutive adult patients with acute dyspnea. They gathered clinical traits, laboratory information, and medication usage at discharge. National data registries were used for follow-up for one year.

One-year all-cause mortality was the study’s main result. A Cox proportional hazards regression model was used to compute the hazard ratios (HRs) for 1-year mortality according to biological sex, with and without adjusting for the confounders of age, systolic blood pressure, creatinine, salt, and hemoglobin. There were 1,455 patients altogether. About 43% of the participants in the research were women. Women’s median (interquartile range [IQR]) ages were higher than men’s [74 (65-80) vs. 68 (59-77) years, P<0.0001]. Women had shorter clinical sign durations prior to admission (4 (1-14) vs. 7(2-14) days, median (IQR) length, P=0.006]. Women had a considerably lower 1-year all-cause mortality rate (21 vs. 28%, P=0.001) than males. Women had a lower adjusted HR for 1-year all-cause mortality than males [HR 0.68 (0.53-0.88), P=0.0028]. The survival advantage for women in subgroups comprising aged more and lower than 75 years, the presence of comorbidities, and the causes of dyspnea were confirmed by additional sensitivity analyses (cardiac or noncardiac).

After the initial ED presentation for acute dyspnea, women survived longer than men do after 1 year. Understanding the biological variations between the sexes should advance precision medicine and enhance clinical judgment to advance gender parity in health.

Reference: journals.lww.com/euro-emergencymed/Abstract/2022/06000/The_association_of_biological_sex_and_long_term.8.aspx