Sex- and Age-Related Differences in Post-Burn Pathophysiology

Area of Science:

• Burn injury research
• Sex differences in medicine
• Immunology and inflammation

Background:

• The impact of sex on burn outcomes and physiological responses is not well understood.
• Existing research presents controversial findings regarding sex-based differences in burn patient outcomes.
• There is a need to explore sex-specific pathophysiological mechanisms following burn injuries.

Purpose of the Study:

• To investigate sex-based differences in clinical outcomes and physiological responses after burn injury.
• To compare outcomes and inflammatory markers between male and female burn patients across different age groups.
• To identify potential sex-specific predictors of mortality and complications in burn patients.

Main Methods:

• Retrospective cohort study including adult burn patients (≥ 18 years) admitted between 2006 and 2021.
• Patients were stratified by sex assigned at birth and age (adult < 60 years vs. older adult ≥ 60 years).
• Comparison of clinical laboratory measures, inflammatory markers, 30-day mortality, in-hospital complications, organ biomarkers, and inflammatory cytokine responses.

Main Results:

• Adult females (vs. males) experienced significantly higher mortality (2% vs. 1%) and skin graft loss (9% vs. 5%).
• Female sex was an independent predictor of mortality in adult burn patients (OR, 3.6).
• Adult females exhibited decreased pro-inflammatory cytokines (IFN-γ, IL-6, IL-1β, TNF-α); older adults showed no significant sex differences in outcomes or inflammatory responses.

Conclusions:

• Adult females demonstrate increased mortality post-burn, linked to distinct inflammatory responses.
• Sex differences in burn outcomes appear to diminish with advancing age.
• Further research into age-related physiological mechanisms is crucial for optimizing burn care.