Sex differences in Emergency Department presentation and risk stratification.

Background
In many diseases, differences between men and women exist in clinical presentation and outcome, but it is unknown whether these sex differences exist in the Emergency Department (ED) setting. If these sex differences exist in the ED, sex adjusted risk stratification may improve outcomes by better recognition of vital threads.

Aims
1. To assess whether sex differences in the ED exist in clinical presentation (age, presenting com-plaints, triage category, vital signs, pain scores, laboratory results, number and type of diagnostic tests) and clinical outcomes (disposition (ward, medium care unit (MCU), intensive care unit (ICU)), in-hospital mortality and ED / hospital length of stay (LOS).
2. To assess whether the association between vital signs, triage category, chief complaints, pain scores and (case-mix adjusted) clinical outcomes are different in men compared to women.
Study design
Observational multi-centre cohort study using the Netherlands Emergency department Evaluation Database (NEED) in which consecutive ED-patients are included.

Data analyses
Descriptive statistics will be used to describe differences between men and women. Multivariable logistic regression analyses will be used to identify independent determinants of clinical outcomes.

Importance and impact
Insight in sex differences of ED presentation and prognosis may contribute to improved recognition of severely ill patients and sex-adjusted risk stratification.

No differences in ED presentation between men and women exist. However, men are at higher risk for mortality.

We study overall in-hospital mortality or ICU admission from the ED. After discharge we don't follow-up on patients.