Sex-Related Differences in Clinical Characteristics and Outcomes Among Emergency Department Patients with Suspected Bacterial Infection

Background and Objectives: Suspected bacterial infection is one of the leading presentations to the Emergency Department (ED) and is still associated with considerable morbidity and mortality. There is increasing evidence that biological sex may influence host immune responses, disease manifestations, therapeutic requirements, and clinical outcomes in infectious diseases. However, sex-specific differences among patients who present to the ED with suspected infection remain incompletely defined. This study, therefore, aimed to assess demographic characteristics, clinical presentation, and clinical management as well as short-term outcomes related to sex among these patients. Materials and Methods: Our single-center retrospective observational study included consecutive adults patients (n= 213) presented with suspected acute bacterial infection to the Emergency Department between June 2025 and August 2025. Results: Female patients were significantly older than male patients (72.13 ± 15.26 vs. 64.25 ± 13.66 years, p < 0.001). Cardiovascular disease and urinary tract infections were more frequently observed among women, whereas men presented significantly higher diastolic blood pressure values at admission (p = 0.004). Vasopressor therapy was more commonly required in female patients compared to males (26.0% vs. 13.3%, p = 0.019). No significant sex-related differences were identified regarding ICU admission or in-hospital mortality. Conclusions: ED patients with suspected bacterial infection demonstrate sex-related differences in age, comorbidities, infection source, and treatment requirements. Female patients were older and more frequently required vasopressor therapy. On the other hand, male patients had higher diastolic blood pressure and presented more frequently with respiratory infections. Short-term outcomes, including ICU admission and in-hospital mortality, were similar for both sexes. These findings highlight the importance of considering sex-specific characteristics in the early assessment and management of suspected infection in the Emergency Department.