To explore sex-based differences in baseline characteristics and complications among patients diagnosed with Posterior Reversible Encephalopathy Syndrome (PRES).

PRES is characterized by seizures, headaches, and visual disturbances. Limited data are available on the influence of sex on its clinical presentation and outcomes.

Using the National Inpatient Sample database between 2016 and 2021, we studied 20,215 patients with PRES. 

Women comprised 70.8% of the cohort and were older (median age 61.0 vs. 58.0 years, p<0.01). They exhibited a lower prevalence of smoking (41.5% vs. 45.9%, p<0.01), chronic kidney disease (31.0% vs. 44.2%, p<0.01), and diabetes (30.5% vs. 34.9%, p<0.01) but had a higher prevalence of obesity (14.9% vs. 11.8%, p<0.01), chronic obstructive pulmonary disease (COPD) (20.8% vs. 14.6%, p<0.01), and malignancy (11.1% vs. 9.5%, p<0.01).

After adjusting for comorbidities, women demonstrated significantly lower odds of acute kidney injury (AKI) (aOR 0.768, p<0.001), hypertensive urgency (aOR 0.814, p<0.001), and hypertensive emergency (aOR 0.854, p<0.001) but had higher odds of seizures (aOR 1.36, p<0.001). No statistically significant sex differences were observed for intracerebral hemorrhage (ICH) (aOR 0.856, p=0.085), non-traumatic subarachnoid hemorrhage (SAH) (aOR 0.981, p=0.903), non-migraine headaches (aOR 0.947, p=0.538), in-hospital mortality (aOR 0.915, p=0.408), or median length of hospital stay (6.0 days, p=0.766).

The prevalence of comorbidities differs between men and women with PRES. Women demonstrated lower aOR for AKI, hypertensive urgency, and hypertensive emergency but were more prone to seizures compared to men.