A multicenter evaluation of whether gender dimorphism affects survival after trauma

Wohltmann, Christopher; Franklin, Glen A.; Boaz, Phillip W.; Luchette, Fred A.; Kearney, Paul A.; Richardson, J. David; Spain, David A.

doi:10.1016/s0002-9610(01)00582-7

Cited by 153 publications

(112 citation statements)

References 16 publications

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“…An earlier sex comparison of TBI also suggested that outcomes and recovery tend to be better in females than in males. 30 Although additional study is needed, a possible explanation is that the higher levels of circulating estrogen and progesterone in females than in males may confer a protective effect against TBI. 23,30 This study also confirms the volume-outcome relationship in TBI operations and the synergistic effects of hospital and surgeon volume.…”

Section: Discussionmentioning

confidence: 99%

“…30 Although additional study is needed, a possible explanation is that the higher levels of circulating estrogen and progesterone in females than in males may confer a protective effect against TBI. 23,30 This study also confirms the volume-outcome relationship in TBI operations and the synergistic effects of hospital and surgeon volume. Finally, the low in-hospital and 5-year mortality rates observed in patients treated by surgeons who had performed a high volume of TBIs in the previous year and the positive association observed between TBI outcomes and volume of surgeries performed by the surgeon and by the hospital in the previous year are consistent with those in other longitudinal studies.…”

Section: Discussionmentioning

confidence: 99%

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Trends and outcome predictors after traumatic brain injury surgery: a nationwide population-based study in Taiwan

Shi¹,

Hwang

Lee³

et al. 2014

JNS

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Object.The authors sought to analyze trends in hospital resource utilization and mortality rates in a population of patients who had received traumatic brain injury (TBI) surgery.Methods. This nationwide population-based cohort study retrospectively analyzed 18,286 patients who had received surgical treatment for TBI between 1998 and 2010. The multiple linear regression model and Cox proportional hazards model were used for multivariate assessment of outcome predictors.Results. The prevalence rate of surgical treatment for patients with TBI gradually but significantly (p < 0.001) increased by 47.6% from 5.0 per 100,000 persons in 1998 to 7.4 per 100,000 persons in 2010. Age, sex, DeyoCharlson comorbidity index score, hospital volume, and surgeon volume were significantly associated with TBI surgery outcomes (p < 0.05). Over the 12-year period analyzed, the estimated mean hospital treatment cost increased 19.06%, whereas the in-hospital mortality rate decreased 10.9%. The estimated mean time of overall survival after TBI surgery (± SD) was 83.0 ± 4.2 months, and the overall in-hospital and 1-, 3-, and 5-year survival rates were 74.5%, 67.3%, 61.1%, and 57.8%, respectively.Conclusions. These data reveal an increased prevalence of TBI, especially in older patients, and an increased hospital treatment cost but a decreased in-hospital mortality rate. Health care providers and patients should recognize that attributes of the patient and of the hospital may affect hospital resource utilization and the mortality rate. These results are relevant not only to other countries with similar population sizes but also to countries with larger populations. (http://thejns.org/doi/abs/10.3171/2014.8.JNS131526) KeY worDS • traumatic brain injury • trends • predictors • hospital resource utilization • mortality rateAbbreviations used in this paper: BNHI = Bureau of National Health Insurance; DCCI = Deyo-Charlson comorbidity index; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; IQR = interquartile range; LOS = length of stay; TBI = traumatic brain injury.* Drs. K. T. Lee and Lin contributed equally to this study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trends and outcome predictors after traumatic brain injury surgery: a nationwide population-based study in Taiwan

Shi¹,

Hwang

Lee³

et al. 2014

JNS

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“…Все отмеченное определяет половые различия реактивности, резистентности и адаптации в норме и при критических состояниях. Действительно, в ряде экспериментальных и клинических исследований выявлен половой диморфизм развития, течения и исхо да критических, терминальных и постреанимационных состояний [12][13][14][15][16][17]. При этом обращает на себя внима ние неоднозначное влияние пола на исход критических состояний разной этиологии.…”

Section: результаты и обсуждениеunclassified

“…Это свидетельствует о необходи мости специфических подходов к защите мозга в зави симости от пола и этиологии критического состояния. В клинических исследованиях [13][14][15] также обнару жено наличие половых особенностей, которые носят неоднозначный характер: девушки легче переносили черепно мозговую травму и тяжелее -инсульт, чем юноши. В целом полученные результаты свидетельст вуют о необходимости выяснения зависимых от пола механизмов развития постреанимационной болезни для разработки специфических методов ее профилак тики и терапии.…”

Section: результаты и обсуждениеunclassified

Sexual Differences in Delayed Postresuscitative Brain Changes (Experimental Study)

Волков¹,

Аврущенко²,

Горенькова³

et al. 2007

rmt

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“…Studies of civilians who have experienced traumatic injury suggest that men patients experience a higher case fatality rate but women experience a greater risk of complications despite their survival advantage [15,35]. Return-to-civilian-work rates after a work-related injury are lower, and total days lost of work are higher for women compared with men [9,28].…”

Section: Introductionmentioning

confidence: 99%

Disability After Deployment Injury: Are Women and Men Service Members Different?

Rivera

Hylden

Johnson

2015

Clinical Orthopaedics &Amp; Related Research

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Background Civilian trauma literature suggests sexual dimorphism in outcomes after trauma. Because women represent an increasing demographic among veterans, the question remains if war trauma outcomes, like civilian trauma outcomes, differ between genders. Questions/purposes (1) Do women service members develop different conditions resulting in long-term disability compared with men service members after injuries sustained during deployment? (2) Do women service members have more or less severe disability after deployment injury compared with men service members? (3) Are men or women more likely to return to duty after combat injury?Methods The Department of Defense Trauma Registry was queried for women injured during deployment from 2001 to 2011. The subjects were then queried in the Physical Evaluation Board database to determine each subject's return-to-duty status and what disabling conditions and disability percentages were assigned to those who did not return to duty. Frequency of disabling conditions, disability percentages, and return-to-duty rates for 368 women were compared with a previously published cohort of 450 men service members, 378 of whom had orthopaedic injuries.Results Women who were unable to return to duty had a higher frequency of arthritic conditions (58% 378] of men, p = 0.0410; RR, 0.169; 95% CI, 0.023-1.224). Women had more severely rated posttraumatic stress disorder (PTSD) compared with men (38% ± 23% versus 19% ± 17%). Forty-eight percent (64 of 133) of battle-injured women were unable to return to active duty, resulting in a lower return-to-duty rate compared with men (34% [450 of 1333]; p = 0.003). Conclusions After deployment-related injury, women have higher rates of arthritis, lower rates of pain disorders, and more severely rated PTSD compared with men. Women are unable to return to duty more often than men injured in combat. These results suggest some difference between men's and women's outcomes after deployment injury, important information for military and Veterans Administration providers seeking to minimize postdeployment disability.

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A multicenter evaluation of whether gender dimorphism affects survival after trauma

Cited by 153 publications

References 16 publications

Trends and outcome predictors after traumatic brain injury surgery: a nationwide population-based study in Taiwan

Trends and outcome predictors after traumatic brain injury surgery: a nationwide population-based study in Taiwan

Sexual Differences in Delayed Postresuscitative Brain Changes (Experimental Study)

Disability After Deployment Injury: Are Women and Men Service Members Different?

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