Gender-related outcomes in trauma

Area of Science:

• Trauma research
• Immunology
• Endocrinology

Background:

• Emerging data suggest sex hormones influence posttraumatic immunosuppression.
• This can lead to gender-specific differences in patient outcomes following injuries.
• This study investigates gender-related outcomes in trauma patients.

Purpose of the Study:

• To examine gender-based differences in outcomes for trauma patients.
• To determine if age influences gender-related outcomes in trauma survivors.

Main Methods:

• Retrospective review of trauma registry data from a Level I trauma center.
• Inclusion criteria: patients > 15 years, Injury Severity Score > 15, survived, mechanical ventilation > 48 hours.
• Patients stratified by age (15-45 and >45 years) and gender, matched for Injury Severity Score, Glasgow Coma Scale, head Abbreviated Injury Score, and transfusion requirements.

Main Results:

• In younger patients (15-45 years), males had higher rates of multiple organ failure, longer intensive care unit (ICU) and hospital lengths of stay (LOS), and increased mortality compared to females (p < 0.05).
• These gender-based outcome disparities were not present in the older age group (>45 years).
• Pneumonia incidence and mortality were higher in patients over 45 years (OR, 2.0; 95% CI, 1.1-3.5).

Conclusions:

• Female trauma patients in the younger age group demonstrated better outcomes than males.
• Gender did not significantly influence outcomes in older trauma patients.
• These findings support a gender-based disparity in outcomes for younger trauma patients.