Sex Differences in Neurological Emergencies Presenting to Multiple Urban Level 1 Trauma Centers

Area of Science:

• Neurology
• Emergency Medicine
• Neuroscience

Background:

• Previous studies suggest sex disparities in neurological emergency treatment and outcomes.
• Limited research exists on the specific role of sex in managing these critical conditions.
• Understanding sex-based pathophysiology is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the prevalence and management of neurological emergencies.
• To evaluate sex differences in the diagnosis and treatment of neurological emergencies.
• To identify potential disparities in care based on sex.

Main Methods:

• Cross-sectional study analyzing 530 adult patients across four level 1 trauma centers.
• Data collected over 4 weeks on patients with chief complaints of neurological emergencies.
• Included conditions: seizures, cerebrovascular events, headache disorders, traumatic brain injuries, CNS infections.

Main Results:

• Female patients had significantly lower rates of neurosurgery and intensive care unit admission compared to males.
• No significant sex differences observed in symptom onset time, transportation, neuroimaging, admission rates, length of stay, or ED disposition.
• Female patients were more likely to have health insurance than males.

Conclusions:

• Sex influences the management of neurological emergencies, particularly regarding neurosurgical intervention and ICU admission.
• While some aspects of care were similar, disparities in treatment intensity exist.
• Further investigation into sex-specific factors is warranted to optimize care for all patients.