IRB-exempt observational cohort study of de-identified patient data spanning a two-year period and 176 hospital emergency departments.

The cohort (n = 8069) was 48% female, median age 71 for women and 65 for men. Women had 30% increased odds of death or in hospice (OR 1.304, 95% CI: 1.183-1.440), which held statistical significance (P < 0.0001). They also had 24% decreased odds of being discharged home (OR: 0.7619, 95% CI: 0.6839-0.8490, P<0.0001).

Age was a contributing factor to patients ending up dead or in hospice (P < 0.0001). For every one-year increase in age, there was a corresponding 2.4% increased odds of death/hospice (OR: 1.024, 95% CI: 1.021-1.028). Both age (P < 0.0001) and gender (P = 0.0069) retained statistical significance under a multivariate logistic regression model (R² = 0.220).

The median length of stay was three days (IQR: 1-8) for women and four days (IQR: 1-9) for men. The trend between age and length of stay was negative; younger patients had a higher length of stay, likely because older patients tended to die sooner. Both age (P < 0.0001) and gender (P = 0.0002) were significant under this regression model (R² = 0.0156).

Even after controlling for age, women were significantly more likely to die or be discharged to hospice. A combination of physiological, social, and geographical components may play a role in differences in outcomes by gender, making it difficult to determine a specific target for improving outcomes in such a devastating diagnosis.