Literature DB >> 26242902

Gender-specific differences in therapy and laboratory parameters and validation of mortality predictors in severely injured patients--results of a German level 1 trauma center.

Carsten Schoeneberg1, Daniel Schmitz2, Sandra Schoeneberg3, Björn Hussmann4, Sven Lendemans5.   

Abstract

PURPOSE: Gender-specific differences in trauma patients have been reported in several studies. There is a lack of knowledge about differences in therapy and laboratory parameters. The objective of this study is to analyze differences between genders, confirming the therapy and laboratory parameters. Additionally, predictors for mortality were validated.
METHODS: Patients on primary admission to the hospital between 2002 and 2012 with an Injury Severity Score (ISS) ≥ 16 were included. 1073 patients met the inclusion criteria. Comparisons and matched-pair analyses between deceased and survived females, males, and between deceased females and males were conducted.
RESULTS: The analyzed laboratory parameters differed between genders, especially the base excess, lactate, and coagulation parameters. In particular, females presented values that were normal or only slightly pathological. The prothrombin ratio was 75.3% in female and 63.2% in male (p = 0.027) and lactate 2.5 mmol/l in female and 3.8 mmol/l in male (p = 0.049). No differences between genders could be found in the initial treatment of severely injured patients. Only the infused volume differed between genders with 1178.2 ml in male and 793.6 ml in female (p = 0.02). The known predictors for mortality, lactate, and prothrombin ratio could not be validated in female trauma patients.
CONCLUSIONS: No gender differences, except the infused volume, in the treatment of severely injured patients could be found. Differences in laboratory tests, especially base excess, lactate, and coagulation parameters were found. As these parameters are also used as predictors of mortality in trauma patients, gender-specific cut-offs of these laboratory tests might be necessary to avoid underestimating injured women.

Entities:  

Keywords:  Gender-specific laboratory values; Gender-specific therapy; Lactate; Mortality rate predictors; Severe trauma

Mesh:

Year:  2015        PMID: 26242902     DOI: 10.1007/s00423-015-1327-6

Source DB:  PubMed          Journal:  Langenbecks Arch Surg        ISSN: 1435-2443            Impact factor:   3.445


  24 in total

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Authors:  L Evans
Journal:  J Trauma       Date:  1988-03

2.  Early coagulopathy in multiple injury: an analysis from the German Trauma Registry on 8724 patients.

Authors:  Marc Maegele; Rolf Lefering; Nedim Yucel; Thorsten Tjardes; Dieter Rixen; Thomas Paffrath; Christian Simanski; Edmund Neugebauer; Bertil Bouillon
Journal:  Injury       Date:  2007-01-09       Impact factor: 2.586

3.  Traumatic brain injury outcomes in pre- and post- menopausal females versus age-matched males.

Authors:  Daniel P Davis; Danielle J Douglas; Wendy Smith; Michael J Sise; Gary M Vilke; Troy L Holbrook; Frank Kennedy; A Brent Eastman; Thomas Velky; David B Hoyt
Journal:  J Neurotrauma       Date:  2006-02       Impact factor: 5.269

4.  Out-of-hospital hypertonic resuscitation after traumatic hypovolemic shock: a randomized, placebo controlled trial.

Authors:  Eileen M Bulger; Susanne May; Jeffery D Kerby; Scott Emerson; Ian G Stiell; Martin A Schreiber; Karen J Brasel; Samuel A Tisherman; Raul Coimbra; Sandro Rizoli; Joseph P Minei; J Steven Hata; George Sopko; David C Evans; David B Hoyt
Journal:  Ann Surg       Date:  2011-03       Impact factor: 12.969

5.  Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes.

Authors:  John R Clarke; Stanley Z Trooskin; Prashant J Doshi; Lloyd Greenwald; Charles J Mode
Journal:  J Trauma       Date:  2002-03

6.  Growing trend in older patients with severe injuries: mortality and mechanisms of injury between 1991 and 2010 at an inner city major trauma centre.

Authors:  Michael M Dinh; Susan Roncal; Christopher M Byrne; Jeffrey Petchell
Journal:  ANZ J Surg       Date:  2012-08-09       Impact factor: 1.872

7.  [Sex and gender differences in pharmacotherapy].

Authors:  V Regitz-Zagrosek
Journal:  Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz       Date:  2014-09       Impact factor: 1.513

Review 8.  Sex differences in stroke: epidemiology, clinical presentation, medical care, and outcomes.

Authors:  Mathew J Reeves; Cheryl D Bushnell; George Howard; Julia Warner Gargano; Pamela W Duncan; Gwen Lynch; Arya Khatiwoda; Lynda Lisabeth
Journal:  Lancet Neurol       Date:  2008-08-21       Impact factor: 44.182

9.  17beta-estradiol mediated protection against vascular leak after hemorrhagic shock: role of estrogen receptors and apoptotic signaling.

Authors:  Ed W Childs; Binu Tharakan; Felicia A Hunter; W Roy Smythe
Journal:  Shock       Date:  2010-09       Impact factor: 3.454

10.  Gender-specific differences in severely injured patients between 2002 and 2011: data analysis with matched-pair analysis.

Authors:  Carsten Schoeneberg; Max Daniel Kauther; Bjoern Hussmann; Judith Keitel; Daniel Schmitz; Sven Lendemans
Journal:  Crit Care       Date:  2013-11-29       Impact factor: 9.097

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