Sepsis in the Emergency Department: Different Faces, Same Fate? A Sex-Based Prognostic Analysis

We aimed to evaluate the clinical characteristics of male and female patients with sepsis and to investigate their potential sex-specific differences in the prognostic weight. Retrospective analysis, including all patients with sepsis admitted to the Emergency Department High-Dependency Unit, between June 2008 and October 2025. Clinical data were collected using a standardized template. The endpoints were day-7 and day-28 mortality rates. The study population included 1527 patients, with a mean age of 74 ± 13 years, and female sex comprising 44%. Women were older (77 ± 13 vs. 73 ± 13 yrs, p ≤ 0.001), with a lower prevalence of cancer (19% vs. 27%, p = 0.009) than men. Conversely, a pulmonary (34% vs. 66%) or abdominal (40% vs. 60%) sepsis source was more frequent in men (both <0.05). The SOFA score was significantly lower in women than in men (5 [3–6] vs. 5 [3–7], p < 0.05), whereas day-7 and day-28 mortality rates were 11% and 22%, respectively, in both sexes. Multivariate analysis identified several independent predictors of 7-day mortality for both sexes. Women and men showed similar clinical characteristics and short- and medium-term mortality, despite a lower grade of organ dysfunction among women.