A multicenter evaluation of whether gender dimorphism affects survival after trauma

• Published in: The American journal of surgery 2001-04, Vol.181 (4), p.297-300
• Main Authors: Wohltmann, Christopher D, Franklin, Glen A, Boaz, Phillip W, Luchette, Fred A, Kearney, Paul A, Richardson, J.David, Spain, David A
• Format: Article
• Language: English
• Subjects: Abdomen; Age; Age factors; Androgens; Biological and medical sciences; Cytokines; Dimorphism; Female; Females; Gender; Gender differences; Hemorrhage; Humans; Injuries; Male; Males; Medical sciences; Men; Middle Aged; Miscellaneous; Mortality; Odds Ratio; Patients; Risk Factors; Sepsis; Sex Characteristics; Survival; Survival Rate; Testosterone; Trauma; Trauma centers; Trauma Severity Indices; Traumas. Diseases due to physical agents; Tumor necrosis factor-TNF; Women; Wounds and Injuries - mortality; Wounds, Nonpenetrating - mortality; Wounds, Penetrating - mortality
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(01)00582-7

Background: The frequency of women who have sustained severe injuries has increased over the past 30 years. The purpose of this study was to evaluate whether severely injured women have a survival advantage over men. To address this issue, we undertook a multicenter evaluation of the effects of gender dimorphism on survival in trauma patients. Methods: Patient information was collected from the databases of three level I trauma centers. We included all consecutive patients who were admitted to these centers over a 4-year period. We evaluated the effects of age, gender, mechanism of injury, pattern of injury, Abbreviated Injury Score (AIS), and Injury Severity Score (ISS) on survival. Results: A total of 20,261 patients were admitted to the three trauma centers. Women who were younger than 50 years of age (mortality rate 5%) experienced a survival advantage over men (mortality rate 7%) of equal age (odds ratio 1.27, P 25) group (mortality rate 28% in women versus 33% in men). This difference was not attributable to mechanism of injury, severity of injury, or pattern of injury. Conclusions: Severely injured women younger than 50 years of age have a survival advantage when compared with men of equal age and injury severity. Young men have a 27% greater chance of dying than women after trauma. We conclude that gender dimorphism affects the survival of patients after trauma.