TY  - JOUR
PY  - 2010//
TI  - Evidence of Hormonal Basis for Improved Survival Among Females With Trauma-Associated Shock: An Analysis of the National Trauma Data Bank
JO  - Journal of trauma
A1  - Haider, Adil H.
A1  - Crompton, Joseph G.
A1  - Chang, David C.
A1  - Efron, David T.
A1  - Haut, Elliott R.
A1  - Handly, Neal
A1  - Cornwell, Edward E.
SP  - 537
EP  - 540
VL  - 69
IS  - 3
N2  - BACKGROUND:: Basic science research suggests that sex hormones affect survival after traumatic shock. This study sought to determine the independent effect of gender on mortality among trauma patients in different hormone-related age groups. METHODS:: Review of severely injured trauma patients with shock included in the National Trauma Databank. Patients were stratified into three groups on the basis of likely hormonal status: prehormonal (age, 0-12 years), hormonal (age,13-64 years), and posthormonal (age, ≥65 years). Multiple logistic regression was used to analyze the independent effect of gender on mortality in each group, adjusting for anatomic and physiologic injury severity. RESULTS:: A total of 48,394 patients met our inclusion criteria (Injury Severity Score ≥16 and systolic blood pressure <90 mm Hg). Crude mortality was higher (p < 0.05) for males in all categories: prehormonal = 29% for males (n = 3,553) versus 24% for females (n = 1,831); hormonal = 34% for males (n = 26,778) versus 30% for females (n = 8,677) and posthormonal = 36% for males (n = 4,280) versus 31% for females (n = 3,275). After adjusting for covariates, women in the hormonally active group had a 14% decreased odds of death (0.86 [95% CI, 0.76-0.93]) compared with men. Females did not exhibit this survival advantage in the prehormonal (odds of death = 0.92 [0.74-1.14]) or posthormonal (odds of death = 0.90 [0.76-1.05]) groups. CONCLUSIONS:: Females aged between 13 and 64 years exhibit significantly lower mortality than males after trauma-associated shock. This outcome difference is lost at the extremes of age (preadolescent children and individuals aged ≥65 years) where the effects of sex hormones are absent or diminished. These findings suggest that hormonal differences play a role in the gender-based outcome disparities after traumatic shock.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-5282
UR  - http://dx.doi.org/10.1097/TA.0b013e3181efc67b
ID  - ref1
ER  -