Society of University SurgeonFemales have fewer complications and lower mortality following trauma than similarly injured males: A risk adjusted analysis of adults in the National Trauma Data Bank
Section snippets
Methods
This was a retrospective analysis of trauma patients entered in the National Trauma Data Bank (NTDB version 7.0; American College of Surgeons National Trauma Data Bank, Chicago, IL) between 2002 and 2006. The NTDB is managed by the American College of Surgeons and it is the largest repository of data on trauma inpatients ever assembled. Data is voluntarily reported from over 700 trauma centers and hospitals that treat trauma patients from across the United States and its territories.
Results
Of 1,897,404 patients included in the NTDB version 7.0, a total of 681,730 patients met inclusion criteria for this study (Fig 1) and approximately two thirds of the patients were males. As shown in Table I, males had a greater proportion of severely injured patients, a higher rate of penetrating trauma, less insurance coverage, and greater proportion of intentional injury compared to females.
Crude mortality was higher among males (3.21%) than among females (2.75%, P < .05). After adjusting for
Discussion
This study demonstrates 3 findings related to gender dimorphism in trauma outcomes. First, adult women with an injury severe enough to require at least a 3-day hospital stay have a survival advantage over equivalently injured males. Second, women exhibit a lower odds of developing life-threatening complications when compared to men of similar age and equivalent injury following trauma. Finally, severe complications of traumatic injury such as acute respiratory distress syndrome, pneumonia,
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Presented as an oral presentation at the Academic Surgical Congress during the proceedings of the Society of University Surgeons on February 4, 2009.
Supported by New Faculty Academic Support Fund (A.H.H.) and the Deans Medical Research Stipend Award (J.G.C.), Johns Hopkins School of Medicine.