K P McGann1, G S Marion, M B Szewczyk, S W Davis. 1. Department of Family and Community Medicine, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1084.
Abstract
BACKGROUND: Sex has been shown to affect the extent of evaluation and treatment of patients with coronary artery disease. This study investigates potential differences in the evaluation of hospitalized men and women with transient ischemic attacks to determine whether a similar bias exists. METHODS: The 1989 MedisGroups comparative database was used to analyze a convenience sample consisting of all family and internal medicine patients with the primary admission diagnosis-related group (DRG) of "transient ischemic attack." RESULTS: Women comprised 1933 of the 3165 admissions. The mean age for women was 1.88 years older than for men (P < .01). Women were three times more likely to reside in a nursing home before admission (P < .01), but had a lower prevalence of dementia (P < .05). The 1232 men had a higher severity of illness score at admission (P < .05), and were 5.3% more likely to be admitted to a teaching hospital than women (P < .01). Men were also more likely than women to be admitted to large hospitals (P < .01). There were no differences between sexes in the use of cranial computed tomography, carotid or cardiac Doppler, or carotid arteriography. Adjusted means for hospital charges, morbidity, and mortality did not differ between sexes, but length of stay was longer by 1.5 days for women compared with men (P < .01). CONCLUSIONS: In-hospital evaluation of elderly patients with transient ischemic attacks did not differ significantly between men and women. This finding does not exclude the possibility of a difference in workup for men as compared with women in the ambulatory management of this condition.
BACKGROUND: Sex has been shown to affect the extent of evaluation and treatment of patients with coronary artery disease. This study investigates potential differences in the evaluation of hospitalized men and women with transient ischemic attacks to determine whether a similar bias exists. METHODS: The 1989 MedisGroups comparative database was used to analyze a convenience sample consisting of all family and internal medicine patients with the primary admission diagnosis-related group (DRG) of "transient ischemic attack." RESULTS:Women comprised 1933 of the 3165 admissions. The mean age for women was 1.88 years older than for men (P < .01). Women were three times more likely to reside in a nursing home before admission (P < .01), but had a lower prevalence of dementia (P < .05). The 1232 men had a higher severity of illness score at admission (P < .05), and were 5.3% more likely to be admitted to a teaching hospital than women (P < .01). Men were also more likely than women to be admitted to large hospitals (P < .01). There were no differences between sexes in the use of cranial computed tomography, carotid or cardiac Doppler, or carotid arteriography. Adjusted means for hospital charges, morbidity, and mortality did not differ between sexes, but length of stay was longer by 1.5 days for women compared with men (P < .01). CONCLUSIONS: In-hospital evaluation of elderly patients with transient ischemic attacks did not differ significantly between men and women. This finding does not exclude the possibility of a difference in workup for men as compared with women in the ambulatory management of this condition.