Sex differences in evaluation and outcome of XXXX .

@entity1 @entity662 @entity712 @entity101 @entity1459 @entity951 @entity299 @entity583 @entity1167 @entity204
CONTEXT: The existence of sex bias in the delivery of cardiac care is controversial, and little is known about the association between sex and delivery of care and outcomes at an early point in the diagnostic sequence, such as when @entity1 present for the evaluation of @entity662 . OBJECTIVE: To test the hypothesis that female sex is negatively associated with care delivered to and outcomes of @entity1 diagnosed as having @entity1459 . DESIGN: Inception population-based cohort study with an average of 6 years of follow-up. SETTING: Emergency departments (EDs) in Olmsted County, Minnesota. @entity1 : A total of 2271 Olmsted County residents (1306 @entity1 and 965 @entity1 ) who presented to the ED for the first time with symptoms meeting criteria for @entity1459 between 1985 and 1992. MAIN OUTCOME MEASURES: Use of cardiac procedures within 90 days of ED visit, overall mortality, and @entity299 ( @entity204 , nonfatal @entity583 , nonfatal @entity1167 , and @entity712 ), compared by sex and Agency for Health Care Policy and Research cardiovascular risk category (low, intermediate, or high). RESULTS: @entity1 were older (P<.001), more likely to have a history of @entity101 (P = .001), and less likely to present with typical @entity951 (P = .004) than @entity1 . @entity1 were more likely than @entity1 to undergo noninvasive cardiac tests (relative risk [RR], 1.27; 95% confidence interval [CI], 1.14-1.40) as well as invasive cardiac procedures (RR, 1.72; 95% CI, 1.51-1.97). After adjustment, male sex was associated with a 24% increase in the use of cardiac procedures. Survival of both @entity1 and @entity1 in the high and intermediate risk categories was significantly lower than expected per the general population (P<.001). @entity1 had a worse outcome than @entity1 , but after multivariate adjustment, male sex was associated with a trend toward an increase in the risk of @entity204 (RR, 1.23; 95% CI, 0.99-1.54) and significantly associated with increased risk of @entity299 (RR, 1.21; 95% CI, 1.03-1.42). CONCLUSIONS: Our population-based data indicate that after an ED visit for symptoms of @entity1459 , the use of cardiac procedures was lower in @entity1 , but after taking into account baseline characteristics, @entity1 experienced worse outcomes.
