Correlation Analysis Of Gender Differences In Outcome Of Severe Blunt Truma

Objective: To investigate the effects of gender on the outcomes of severe blunt trauma and the underlying factors that can contribute to these effects.Methods: This retrospective analysis of patients who suffered from severe blunt trauma,registered and treated in the First Affiliated Hospital of Guangxi Medical University during January 2015 to January 2018.The cases were stratified by age and ISS:16 years?age?50years,50years<age? 65 years,16points?ISS < 25 points,25points?ISS,females were stratified by menstrual history into premenopausal group or postmenopausal group.The logistic regression model was used to analyze the association between sex and mortality.Results:1.A total of 324 patients were enrolled in this retrospective analysis,203 males and 121 females,with a total of 43 deaths(10 males and 10females).The main causes of death were pneumonia and MODS(female 6/10 vs.male 21/33).2.The crude hospital mortality rate of female patients was lower than males(8.26% vs.16.26%,P=0.04).Logistic regression analysis showed that the hospital mortality rate of female patients was 75% lower than males(OR=0.25,95% CI: 0.08~0.76,P= 0.015).3.There were no significant difference in some complications between male and female,such as ARDS,ARF,pulmonary embolism,MODS,sepsis,abdominal abscess,urinary tract infection,but the rate of post-traumatic pneumonia in female patients was significantly lower than males(23.96% vs.56.65%,P= 0.000).4.In the subgroup,16 years?age ? 50 years,the hospital mortality rate of female was significantly lower than males(3.70% vs.15.00%,P=0.009),mainly because there was significant difference in the rate of the hospital mortality between females and males with ISS ? 25 points(7.14% vs.38.30%,P=0.003).but in the group of 50years<age? 65 years,There was no significant difference in the hospital mortality rate between females and males(17.50% vs.19.05%,P=0.844).5.In the subgroup,the hospital mortality rate of premenopausal women was lower than postmenopausal women(3.75% vs.17.07%,P=0.030).Logistic regression analysis showed that the hospital mortality rate of premenopausal women was 84% lower than postmenopausal women(OR=0.16,95%CI:0.03~0.74,P=0.020)Conclusion: This study showed that gender has an important effect on the outcomes of severe blunt trauma,Estrogen levels may be the underlying cause.