Journal article
Evidence of Hormonal Basis for Improved Survival Among Females With Trauma-Associated Shock: An Analysis of the National Trauma Data Bank
The journal of trauma, v 69(3), pp 537-540
01 Sep 2010
PMID: 20838123
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Basic science research suggests that sex hormones affect survival after traumatic shock. This study sought to determine the independent effect of gender on mortality among trauma patients in different hormone-related age groups.
Methods: Review of severely injured trauma patients with shock included in the National Trauma Databank. Patients were stratified into three groups on the basis of likely hormonal status: prehormonal (age, 0-12 years), hormonal (age, 13-64 years), and posthormonal (age, >= 65 years). Multiple logistic regression was used to analyze the independent effect of gender on mortality in each group, adjusting for anatomic and physiologic injury severity.
Results: A total of 48,394 patients met our inclusion criteria (Injury Severity Score >= 16 and systolic blood pressure <90 mm Hg). Crude mortality was higher (p < 0.05) for males in all categories: prehormonal = 29% for males (n = 3,553) versus 24% for females (n = 1,831); hormonal = 34% for males (n = 26,778) versus 30% for females (n = 8,677) and posthormonal = 36% for males (n = 4,280) versus 31% for females (n = 3,275). After adjusting for covariates, women in the hormonally active group had a 14% decreased odds of death (0.86 [ 95% CI, 0.76-0.93]) compared with men. Females did not exhibit this survival advantage in the prehormonal (odds of death = 0.92 [0.74-1.14]) or posthormonal (odds of death = 0.90 [0.76-1.05]) groups.
Conclusions: Females aged between 13 and 64 years exhibit significantly lower mortality than males after trauma-associated shock. This outcome difference is lost at the extremes of age (preadolescent children and individuals aged >= 65 years) where the effects of sex hormones are absent or diminished. These findings suggest that hormonal differences play a role in the gender-based outcome disparities after traumatic shock.
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Details
- Title
- Evidence of Hormonal Basis for Improved Survival Among Females With Trauma-Associated Shock: An Analysis of the National Trauma Data Bank
- Creators
- Adil H. Haider - Johns Hopkins UniversityJoseph G. Crompton - Johns Hopkins UniversityDavid C. Chang - Johns Hopkins UniversityDavid T. Efron - Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD 21205 USAElliott R. Haut - Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD 21205 USANeal Handly - Drexel UniversityEdward E. Cornwell - Howard University
- Publication Details
- The journal of trauma, v 69(3), pp 537-540
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 4
- Grant note
- Johns Hopkins School of Medicine, Department of Surgery
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Emergency Medicine
- Web of Science ID
- WOS:000281760800011
- Scopus ID
- 2-s2.0-77957553805
- Other Identifier
- 991019167784504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Surgery