Female gender does not protect blunt trauma patients from complications and mortality.
BACKGROUND
The protective effect of gender on posttraumatic mortality or acute complications (acute respiratory distress syndrome [ARDS], pneumonia, and sepsis) is unclear. To assess potential effects, we performed a retrospective case-controlled study, matching patients for injury factors including overall severity (Injury Severity Sscore), the presence of shock (systolic blood pressure [SBP] < 90 mm Hg) at admission, and the presence of closed head injury (CHI).


METHODS
All female patients admitted over a 61/2-year period were reviewed and divided into four groups: group 1, SBP > 90, no CHI; group 2, SBP < 90, no CHI; group 3, SBP > 90, with CHI; and group 4, SBP < 90, with CHI. Each cohort was matched one to one with an equivalent male counterpart. Cohorts were compared for mortality or the development of ARDS, pneumonia, and systemic sepsis using standard definitions.


RESULTS
Overall, 1,229 female patients were identified for study. The average Injury Severity Score was 16.3 and overall mortality was 2.7%. Analysis of the groups described previously demonstrated no statistically significant difference in the development of ARDS, pneumonia, systemic sepsis, or overall mortality between male and female patients including patients presenting with shock, CHI, or both.


CONCLUSIONS
We conclude that female gender offers no protection from the development of ARDS, pneumonia, sepsis, or decreased mortality after blunt trauma.
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000150:complications / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000401:mortality; D012042:Registries; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000401:mortality; D012189:Retrospective Studies; D012737:Sex Factors; D012774:Shock, Traumatic / Q000150:complications / Q000401:mortality; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality* / Q000473:pathology