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. 2013 Nov 29;17(6):R277.
doi: 10.1186/cc13132.

Gender-specific differences in severely injured patients between 2002 and 2011: data analysis with matched-pair analysis

Carsten Schoeneberg, Max Daniel Kauther, Bjoern Hussmann, Judith Keitel, Daniel Schmitz, Sven Lendemans

Gender-specific differences in severely injured patients between 2002 and 2011: data analysis with matched-pair analysis

Carsten Schoeneberg et al. Crit Care. .

Abstract

Introduction: Previous studies reported divergent results concerning the effect of gender on patient outcome after severe injury. Results suggest that women have better outcomes because they have lower rates of sepsis and multi-organ failure. The objective of this analysis was to study gender differences in a Level 1 trauma center in Germany.

Methods: Patients who were admitted to hospital between 2002 and 2011 with an Injury Severity Score (ISS) ≥16 were included. Data were collected from the Trauma Registry of the German Society for Trauma Surgery and from hospital records. The effects of gender on a variety of parameters were investigated. To eliminate the influence of differences in ISS, an analysis of groups with similar ISS was performed. Also, a matched-pair analysis of 422 patients was performed.

Results: A total of 962 patients met the inclusion criteria. The mortality rate was lower in male patients (25.4% versus 36.59%). Female patients had more severe head injuries, received less fluid volume and had a lower rate of sepsis. Men were more frequently involved in motorcycle accidents and sustained more penetrating trauma. Women were more frequently involved in pedestrian accidents and sustained more falls from under 3 m. The effects of gender were reduced when the data were analyzed by matching ISS. The mortality rate was significantly different in the ISS 26 to 35 group but in mostly all groups, the mortality rate was higher in women. In the matched-pair analysis, the rate of sepsis and the length of the ICU stay were significantly lower in women and the mortality rate showed no significant difference (28.1% for male patients versus 33.01% for female patients). Women died after an average of 5.22 days, and men died after an average of 9.02 days.

Conclusions: Gender-based differences in patient outcome after severe trauma were observed in this study. Women are more likely to die in the first days after trauma. Upon extended hospital stay, women had a better survival rate because they had a lower rate of sepsis. No significant differences in mortality rate could be found, but there was a trend towards a higher rate in female patients.

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Figures

Figure 1
Figure 1
Annual mortality rate divided by gender.
Figure 2
Figure 2
Gender-based mortality and revised injury severity classification in different injury severity score groups. ISS, Injury Severity Score; RISC, Revised Injury Severity Classification.
Figure 3
Figure 3
Gender difference in time to death.
See this image and copyright information in PMC

Comment in

References

    1. Pfeifer R, Tarkin IS, Rocos B, Pape HC. Patterns of mortality and causes of death in polytrauma patients – has anything changed? Injury. 2009;17:907–911. doi: 10.1016/j.injury.2009.05.006. - DOI - PubMed
    1. Evans L. Risk of fatality from physical trauma versus sex and age. J Trauma. 1988;17:368–378. doi: 10.1097/00005373-198803000-00013. - DOI - PubMed
    1. Eachempati SR, Hydo L, Barie PS. Gender-based differences in outcome in patients with sepsis. Arch Surg. 1999;17:1342–1347. doi: 10.1001/archsurg.134.12.1342. - DOI - PubMed
    1. Wohltmann CD, Franklin GA, Boaz PW, Luchette FA, Kearney PA, Richardson JD, Spain DA. A multicenter evaluation of whether gender dimorphism affects survival after trauma. Am J Surg. 2001;17:297–300. doi: 10.1016/S0002-9610(01)00582-7. - DOI - PubMed
    1. Davis DP, Douglas DJ, Smith W, Sise MJ, Vilke GM, Holbrook TL, Kennedy F, Eastman AB, Velky T, Hoyt DB. Traumatic brain injury outcomes in pre- and post-menopausal females versus age-matched males. J Neurotrauma. 2006;17:140–148. doi: 10.1089/neu.2006.23.140. - DOI - PubMed

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