BackgroundFemale patients present with unique physiological and behavioral characteristics compared to male patients. The aim of this study was to investigate and compare the injury patterns, injury characteristics, and mortality of male and female patients hospitalized for treatment of motorcycle accident-related trauma in a level I trauma center.MethodsRetrospective analysis of motorcycle-related injuries from the Trauma Registry System was performed to identify and compare 4028 male and 2919 female patients hospitalized for treatment between January 1, 2009 and December 31, 2013.ResultsThe female patients were younger, less often drunken, more often wore helmets, were transported by emergency medical services, and arrived at the emergency department between 7 a.m. and 5 p.m. compared to male patients. Analysis of Abbreviated Injury Scale scores revealed that female patients sustained significantly higher rates of injuries to the extremities, but lower rates of injuries to the head/neck, face, and thorax than male patients did. Female patients had a significant lower Injury Severity Score (ISS) and adjusted odds ratio of in-hospital mortality (AOR 0.83, 95% CI: 0.83–0.86) after adjustment by ISS. However, the logistic regression analysis of propensity score-matched patients with adjusted confounders including helmet-wearing status and alcohol intoxication revealed that the gender did not significantly influence mortality (OR 0.82, 95% CI 0.47–1.43; p = 0.475), implying the an associated risky behaviors may attribute to the difference of odds of mortality between the male and female patients. In addition, a significantly fewer female patients were admitted to the intensive care unit (ICU), and female patients had a significantly shorter hospital and ICU length of stay.ConclusionFemale motorcycle riders have different injury characteristics, lower ISS and in-hospital mortality, and present with a bodily injury pattern that differs from that of male motorcycle riders.Level of evidenceEpidemiologic study, level III.
Aims: Single-incision vaginal mesh (SIVM) procedures for pelvic organ prolapse (POP) differed in mesh fabrication and implantation that may affect treatment outcomes. We aim to evaluate and compare the safety and effectiveness of two SIVM procedures, and explore factors that may have associations with surgical effectiveness. Methods: Our data of using two SIVM procedures for a total (anterior and posterior) vaginal mesh repair were studied. Patients who had ≧stage 2 POP and underwent either Elevate (n = 85) using anchored, lightweight meshes or Prosima procedures (n = 95) using non-anchored, original meshes were assessed. A detailed comparison of 1 year outcomes was made. Results: Of the 180 patients, 172 (95.6%) attended the 1-year follow-up. Demographic data were similar between groups except a higher average age (64.5 vs 60.4, P = 0.001) was noted in the Elevate (n = 84) group compared to the Prosima (n = 88) group. Surgical results were also similar except a significantly higher objective cure (POP stage ≦1) rate (89.3% vs 78.4%, P = 0.042) was noted in the Elevate group. The safety profile favored Elevate with a lower, but not statistically significant, rate (4.7% vs 12.5%, P = 0.106) of vaginal mesh exposure. After a statistical analysis, we found anatomic recurrence (POP stage ≧2) after the SIVM procedures had strong (P < 0.05) associations with "early surgical cases," "Prosima procedure," "advanced cystocele (Ba > +3 cm)," and "prior prolapse repair," respectively. Conclusions: Beyond a learning curve, Elevate performed better than Prosima in POP repair regarding surgical effectiveness. Meanwhile, several predisposing factors that may affect recurrence after SIVM procedures were found. K E Y W O R D Slightweight, pelvic organ prolapse, reconstructive pelvic surgery, single-incision, vaginal meshes
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