Sex Differences in Traumatic Injuries at a Tertiary Trauma Center in South Africa

Sex differences in trauma exist across multiple settings, and understanding these differences is key to proper patient care. This study aimed to characterize injury patterns for female patients and compare them to male patients at a South African trauma center.

Patients admitted to a single large academic trauma center in South Africa from December 2012 to June 2024 were retrospectively reviewed. Sex differences, injury patterns, and outcomes were descriptively analyzed.

Of 19,873 included patients, 3421 (17.2%) were female. Females were more likely to experience blunt trauma (70.6% versus 53.2%; P < 0.01), bites (4.1% versus 1.1%; P < 0.01), and burns (0.2% versus 0.1%; P = 0.05) compared to males. For blunt trauma, females had greater percentages of motor or pedestrian vehicle collisions (55.6% versus 38.9%; P < 0.01) and falls (22.2% versus 14.4%; P < 0.01). For penetrating trauma, a higher proportion of injuries were from gunshot wounds among females (41.4% versus 33.2%; P < 0.01). Interpersonal violence accounted for 35.1% of female trauma and 64.5% of male trauma. Females sustained more injuries to the head (54.9% versus 51.5%; P = 0.01), pelvis (11.0% versus 5.9%; P < 0.01), and extremities (38.9% versus 29.9%; P < 0.01). Females presented with higher mean Injury Severity Scores for penetrating injuries (9.4 versus 9.0; P = 0.04) and were less likely to be transferred for subspecialty care (6.8% versus 9.2%; P < 0.01) and receive surgery (19.7% versus 24.0%; P < 0.01).

There are significant differences in injury patterns between female and male trauma patients in South Africa. Seeking to understand these differences may be helpful in individualizing treatment and injury prevention efforts for these patients.