Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis

Abstract

The Osteoporosis Self-assessment Tool for Asians (OSTA) is a validated index based on age and weight to predict the risk of osteoporosis in women. This cross-sectional study was designed to evaluate the impact of sexual dimorphism on the trauma patterns and the clinical outcomes of patients with high-risk OSTA scores. Trauma data of patients with high-risk OSTA scores between 1 January 2009 and 31 December 2015 were retrieved from the trauma registry system of a level I trauma center. A total of 2248 patients including 1585 women and 663 men were included in this study. In-hospital mortality was assessed as the primary outcome in the propensity score-matched analyses of the female and male patients, which were created in a 1:1 ratio under the adjustment of potential confounders, including age, co-morbidity, mechanism and injury-severity score (ISS). Female patients with a high-risk OSTA score had significantly lower mortality rates than their male counterparts. Among the propensity score-matched population, female patients had lower odds of having cerebral contusion and pneumothorax, but higher odds of presenting with radial, ulnar and femoral fractures than male patients. In addition, the female patients still had significantly lower odds of mortality (odds ratio (OR), 0.5; 95% confidence interval (CI), 0.29–0.90; p = 0.019) than the male patients. However, no significant differences were noted in the length of stay (LOS) in hospital, intensive-care unit (ICU) admission, and LOS in the ICU between the sexes. Female patients with high-risk OSTA scores showed different injury patterns and significantly lower mortality rates than their male counterparts, even after controlling for potential confounding factors.

Geriatric Nutritional Risk Index as a Screening Tool to Identify Patients with Malnutrition at a High Risk of In-Hospital Mortality among Elderly Patients with Femoral Fractures—A Retrospective Study in a Level I Trauma Center

“…Elderly individuals are at the greatest risk of a fall accidents [1,2] and their consequences, such as fractures, immobility, and sometimes even death [3][4][5][6][7]. In addition to pain, a femoral fracture results in a curtailment of physical activity, increased dependence, and rapid worsening of the health status.…”

The Association between Skull Bone Fractures and the Mortality Outcomes of Patients with Traumatic Brain Injury

“…In this study, females accounted for a small proportion (25.9%) of skull fracture patients, which is consistent with the results of a previous study that revealed gender differences in head trauma [ 5 , 28 ]. Our previous studies also reported that more males than females sustained TBI in road accidents [ 18 , 29 ]. The study results did not identify gender as a significant risk factor for mortality, which is in accordance with reports from other studies [ 10 – 14 ].…”

Impact of Adapting the Abbreviated Injury Scale (AIS)-2005 from AIS-1998 on Injury Severity Scores and Clinical Outcome

“…The study double-coded the injuries for all 7520 consecutively admitted trauma patients during a three-year period between 1 January, 2016, and 31 December, 2018, by two certified specialists who had been trained for coding and experienced for three and ten years, respectively, in trauma registry at Taiwan. The study hospital is a level I trauma center in the Kaohsiung city, Taiwan [18][19][20] and serves around three millions patients in southern Taiwan with another two level I trauma centers [21][22][23][24]. About thirty thousand trauma patients had visited the emergency department of this hospital and, among them, there were around 3600 hospitalizations per year.…”