Incidence of Septic Complications and Multiple Organ Failure in Severely Injured Patients Is Sex Specific

Oberholzer, Andreas; Keel, Marius; Zellweger, René; Steckholzer, Ursula; Trentz, O.; Ertel, Wolfgang

doi:10.1097/00005373-200005000-00019

Cited by 224 publications

(183 citation statements)

References 29 publications

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“…In contrast, previous studies have found sepsis and multiple organ dysfunction to be less common in females after traumatic injuries. 32,33 Patients in our analyses who survived to 48 hr may resemble the generally critically ill population in which older women have a higher risk of ICU mortality compared with older men. 34 Finally, there was only a weak inverse correlation between nadir hemoglobin and red blood cell units transfused in the analysis of hospital mortality in 48-hr survivors.…”

Section: Discussionmentioning

confidence: 99%

Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

Mahambrey

Fowler

Pinto

et al. 2009

Can J Anesth/J Can Anesth

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Purpose To determine associations between red blood cell (RBC) transfusion and early and late clinical outcomes in massively transfused adult trauma patients. Methods A retrospective cohort study (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001) including 260 patients receiving C10 RBC units B24 hr after admission to a university-affiliated trauma centre. We extracted demographic and clinical data and used multivariable regression to determine independent effects of RBC transfusion on clinical outcomes. ]).Conclusions Hospital mortality is high among massively transfused trauma patients. Among early survivors, 48-hr RBC transfusion volume is associated with increased organ dysfunction, but not hospital mortality. Also, it is not associated with 48-hr mortality. Future research should continue to explore methods to improve hemostasis and minimize the need for RBC transfusion. RésuméObjectif De´terminer les associations qui existent entre la transfusion d'e´rythrocytes et les devenirs cliniques R. A. Fowler and N. K. J. Adhikari contributed equally to this study.

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Section: Discussionmentioning

confidence: 99%

Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

Mahambrey

Fowler

Pinto

et al. 2009

Can J Anesth/J Can Anesth

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“…PCT seems to be a good marker for monitoring the status of inflammatory reaction in patients suffering from multiple trauma [12], although significant gender differences between men and women have been found [13]. Experiments have shown that hepatic tissue stimulated by TNF-alpha or Table 2.…”

Section: Discussionmentioning

confidence: 99%

“…Peak values are observed in the first 24 hours and around the 3 rd day following trauma. High levels of PCT during the first days after injury are believed to be a prognostic factor in severe systemic inflammatory response syndrome (SIRS), infection or multiple organ dysfunction syndrome (MODS) [12][13][14][15][16].…”

mentioning

confidence: 99%

Changes of procalcitonin level in multiple trauma patients

Wojtaszek¹,

Staśkiewicz²,

Torres³

et al. 2014

Anaesthesiol Intensive Ther

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Background: Some aspects of the pathophysiology of complications in multiple-trauma patients still remain unclear. Mediators of inflammation have been postulated as playing a key role in being responsible for life threatening complications of multiple trauma patients. The objective of this study was to evaluate the prognostic value of procalcitonin (PCT) level in multiple trauma patients. Methods: A prospective study took place including patients with multiple trauma hospitalised in several hospital units. PCT level was measured in blood from 45 patients, aged 18-70 years using enzyme-linked immunoassay. The patients were divided into three groups: group I -individuals with multiple trauma with central nervous system injury; group II -those with multiple trauma without CNS injury; and group III -patients with isolated central nervous system injury. Results: Initial PCT levels were below 0.5 ng mL -1 regardless of the cause of trauma. In the 24 th hour of observation, a statistically significant increase of PCT concentration vs. initial levels was recorded in all groups of patients. Then PCT levels decreased significantly at the 3 rd measurement point in all groups, and they remained unchanged until the last measurement. The highest levels of PCT were observed in multiple trauma patients without CNS injury (group II). In this group of patients, a significantly longer duration of surgery in the post-trauma period affected PCT levels. PCT concentrations in patients who died were significantly greater than in survivors. Conclusions: A long lasting elevated concentration of procalcitonin in the post-traumatic period, or its repeated increase, is a good marker of developing complications observed earlier than clinical manifestations.

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“…Female sex hormones play an important role in the preservation of functionality of various organs and systems. As female rats present a better response to shock, trauma and sepsis when compared to male rats, several studies state that female hormones (estradiol, mainly) have a protective action modulating the generation of inflammatory mediators [13][14][15] . It has been shown that estrogen is also a protective factor to infections, reason why women would be more resistant than men 14 .…”

Section: Introductionmentioning

confidence: 99%

“…As female rats present a better response to shock, trauma and sepsis when compared to male rats, several studies state that female hormones (estradiol, mainly) have a protective action modulating the generation of inflammatory mediators [13][14][15] . It has been shown that estrogen is also a protective factor to infections, reason why women would be more resistant than men 14 . Furthermore, it has been demonstrated the presence of estradiol receptors (subtypes α and β) on lymphocytes, neutrophils, macrophages, dendritic cells and NK lymphocytes, suggesting that estrogens may play a role in immunocompetence regulation 16 .…”

Section: Introductionmentioning

confidence: 99%

Sex differences on solid organ histological characteristics after brain death1

Simão

Ferreira²,

Kudo³

et al. 2016

Acta Cir. Bras.

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Brazil. CNPq Researcher, level 1D. Scientific and intellectual content of the study; conception and design of the study; analysis and interpretation of data; statistical analysis; manuscript preparation and writing; critical revision; final approval. ABSTRACT PURPOSE:To investigate gender differences in the evolution of the inflammatory process in rats subjected to brain death (BD). METHODS:Adult Wistar rats were divided into three groups: female; ovariectomized female; and male rats. BD was induced using intracranial balloon inflation and confirmed by maximal pupil dilatation, apnea, absence of reflex, and drop of mean arterial pressure. Six hours after BD, histological evaluation was performed in lungs, heart, liver and kidneys, and levels of inflammatory proteins, estrogen, progesterone, and corticosterone were determined in plasma. RESULTS:In the lungs, females presented more leukocyte infiltration compared to males (p<0.01). Ovariectomized female rat lungs were more hemorrhagic compared to other groups (p<0.001). In the heart, females had higher leukocyte infiltration and tissue edema compared to males (p<0.05). In the liver and kidneys, there were no differences among groups. In female group estradiol and progesterone were sharply reduced 6 hours after BD (p<0.001) to values observed in ovariectomized females and males. Corticosterone levels were similar. CONCLUSIONS:Sex hormones influence the development of inflammation and the status of organs. The increased inflammation in lungs and heart of female rats might be associated with the acute reduction in female hormones triggered by BD.

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Incidence of Septic Complications and Multiple Organ Failure in Severely Injured Patients Is Sex Specific

Abstract: Sex influences posttraumatic morbidity in severely injured patients and supports the concept that females are immunologically better positioned toward a septic challenge.

Cited by 224 publications

References 29 publications

Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

Early massive transfusion in trauma patients: Canadian single-centre retrospective cohort study

Changes of procalcitonin level in multiple trauma patients

Sex differences on solid organ histological characteristics after brain death1

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