Citation

van Wonderen SF, Pape M, Zuidema WP, Edwards MJR, Verhofstad MHJ, Tromp TN, Van Lieshout EMM, Bloemers FW, Geeraedts LMGJ. J. Clin. Med. 2023; 12(11).

Copyright

(Copyright © 2023, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/jcm12113701

PMID

37297896

PMCID

PMC10253981

Abstract

BACKGROUND: The objective of this study was to determine the association between sex and outcome among severely injured patients who were admitted in severe shock.

METHODS: A retrospective multicenter study was performed in trauma patients (Injury Severity Score (ISS) ≥ 16) aged ≥ 16 presenting with severe shock (Shock Index > 1.3) over a 4-year period. To determine if sex was associated with mortality, Intensive Care Unit (ICU) admission, mechanical ventilation, blood transfusion and in-hospital complications, multivariable logistic regressions were performed.

RESULTS: In total, 189 patients were admitted to the Emergency Department in severe shock. Multivariable logistic regression analysis showed that female sex was independently associated with a decreased likelihood of acute kidney injury (OR 0.184; 95% CI 0.041-0.823; p = 0.041) compared to the male sex. A significant association between female sex and mortality, ICU admission, mechanical ventilation, other complications and packed red blood cells transfusion after admission could not be confirmed.

CONCLUSION: Female trauma patients in severe shock were significantly less likely to develop AKI during hospital stay. These results could suggest that female trauma patients may manifest a better-preserved physiologic response to severe shock when compared to their male counterparts. Prospective studies with a larger study population are warranted.

Language: en

Keywords

shock; trauma; mortality; ICU; AKI; hemorrhage; packed red blood cells; sex dimorphism