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Differential Patterns and Outcomes of 20.6 Million Cardiovascular Emergency Department Encounters for Men and Women in the United States

Raisi‐Estabragh, Zahra; Kobo, Ofer; Elbadawi, Ayman; Velagapudi, Poonam; Sharma, Garima; Bullock‐Palmer, Renee P.; Petersen, Steffen E.; Mehta, Laxmi S.; Ullah, Waqas; Roguin, Ariel; Sun, Louise Y.; Mamas, Mamas A.

Differential Patterns and Outcomes of 20.6 Million Cardiovascular Emergency Department Encounters for Men and Women in the United States Thumbnail


Authors

Zahra Raisi‐Estabragh

Ofer Kobo

Ayman Elbadawi

Poonam Velagapudi

Garima Sharma

Renee P. Bullock‐Palmer

Steffen E. Petersen

Laxmi S. Mehta

Waqas Ullah

Ariel Roguin

Louise Y. Sun



Abstract

Background We describe sex‐differential disease patterns and outcomes of >20.6 million cardiovascular emergency department encounters in the United States. Methods and Results We analyzed primary cardiovascular encounters from the Nationwide Emergency Department Sample between 2016 and 2018. We grouped cardiovascular diagnoses into 15 disease categories. The sample included 48.7% women; median age was 67 (interquartile range, 54–78) years. Men had greater overall baseline comorbidity burden; however, women had higher rates of obesity, hypertension, and cerebrovascular disease. For women, the most common emergency department encounters were essential hypertension (16.0%), hypertensive heart or kidney disease (14.1%), and atrial fibrillation/flutter (10.2%). For men, the most common encounters were hypertensive heart or kidney disease (14.7%), essential hypertension (10.8%), and acute myocardial infarction (10.7%). Women were more likely to present with essential hypertension, hypertensive crisis, atrial fibrillation/flutter, supraventricular tachycardia, pulmonary embolism, or ischemic stroke. Men were more likely to present with acute myocardial infarction or cardiac arrest. In logistic regression models adjusted for baseline covariates, compared with men, women with intracranial hemorrhage had higher risk of hospitalization and death. Women presenting with pulmonary embolism or deep vein thrombosis were less likely to be hospitalized. Women with aortic aneurysm/dissection had higher odds of hospitalization and death. Men were more likely to die following presentations with hypertensive heart or kidney disease, atrial fibrillation/flutter, acute myocardial infarction, or cardiac arrest. Conclusions In this large nationally representative sample of cardiovascular emergency department presentations, we demonstrate significant sex differences in disease distribution, hospitalization, and death.

Citation

Raisi‐Estabragh, Z., Kobo, O., Elbadawi, A., Velagapudi, P., Sharma, G., Bullock‐Palmer, R. P., …Mamas, M. A. (2022). Differential Patterns and Outcomes of 20.6 Million Cardiovascular Emergency Department Encounters for Men and Women in the United States. Journal of the American Heart Association, 11(19), 1-19. https://doi.org/10.1161/JAHA.122.026432

Journal Article Type Article
Acceptance Date Jul 19, 2022
Online Publication Date Sep 8, 2022
Publication Date Oct 4, 2022
Publicly Available Date May 30, 2023
Journal Journal of the American Heart Association
Publisher Wiley Open Access
Volume 11
Issue 19
Article Number e026432
Pages 1-19
DOI https://doi.org/10.1161/JAHA.122.026432
Public URL https://keele-repository.worktribe.com/output/423705
Publisher URL https://www.ahajournals.org/doi/10.1161/JAHA.122.026432

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