Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Oct 26;5(1):35.
doi: 10.1186/s40779-018-0182-5.

Gender differences in trauma, shock and sepsis

Florian Bösch  1 , Martin K Angele  1 , Irshad H Chaudry  2
Affiliations
Review

Gender differences in trauma, shock and sepsis

Florian Bösch et al. Mil Med Res. .

Abstract

Despite efforts in prevention and intensive care, trauma and subsequent sepsis are still associated with a high mortality rate. Traumatic injury remains the main cause of death in people younger than 45 years and is thus a source of immense social and economic burden. In recent years, the knowledge concerning gender medicine has continuously increased. A number of studies have reported gender dimorphism in terms of response to trauma, shock and sepsis. However, the advantageous outcome following trauma-hemorrhage in females is not due only to sex. Rather, it is due to the prevailing hormonal milieu of the victim. In this respect, various experimental and clinical studies have demonstrated beneficial effects of estrogen for the central nervous system, the cardiopulmonary system, the liver, the kidneys, the immune system, and for the overall survival of the host. Nonetheless, there remains a gap between the bench and the bedside. This is most likely because clinical studies have not accounted for the estrus cycle. This review attempts to provide an overview of the current level of knowledge and highlights the most important organ systems responding to trauma, shock and sepsis. There continues to be a need for clinical studies on the prevailing hormonal milieu following trauma, shock and sepsis.

Keywords: Cardiopulmonary bypass; Estrogens; Gender morphism; Hormonal milieu; Trauma-hemorrhage.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Not applicable

Consent for publication

Not applicable

Competing interests

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Trauma, shock and sepsis have several deleterious effects on organ systems depending on gender and the prevailing hormonal milieu
Fig. 2
Fig. 2
Protective effects of 17β-estradiol on the CNS, heart, lung, liver, kidney and immune cells CNS: central nervous system; HSP: heat shock protein; HO-1: heme oxygenase-1; IRI: ischemia-reperfusion injury; IL-6: interleukin-6
See this image and copyright information in PMC

References

    1. Ren C, Zhang H, Wu TT, Yao YM. Autophagy: A potential therapeutic target for reversing sepsis-induced immunosuppression. Front Immunol. 2017;8:1832. doi: 10.3389/fimmu.2017.01832. - DOI - PMC - PubMed
    1. Runge JW. The cost of injury. Emerg Med Clin North Am. 1993;11(1):241–253. - PubMed
    1. Faul M, Coronado V. Epidemiology of traumatic brain injury. Handbook Clin Neurol. 2015;127:3–13. doi: 10.1016/B978-0-444-52892-6.00001-5. - DOI - PubMed
    1. Rossaint R, Cerny V, Coats TJ, Duranteau J, Fernandez-Mondejar E, Gordini G, et al. Key issues in advanced bleeding care in trauma. Shock. 2006;26(4):322–331. doi: 10.1097/01.shk.0000225403.15722.e9. - DOI - PubMed
    1. Rutland-Brown W, Langlois JA, Thomas KE, Xi YL. Incidence of traumatic brain injury in the united states, 2003. J Head Trauma Rehabil. 2006;21(6):544–548. doi: 10.1097/00001199-200611000-00009. - DOI - PubMed

Publication types