title: Association between male sex and increased mortality after falls.
abstract: OBJECTIVE
  Whether sex affects the mortality of trauma patients remains unknown. The hypothesis of this study was that sex was associated with altered mortality rates in trauma.
  
  
  METHODS
  A retrospective review of trauma patients' records in the Japan Trauma Data Bank was conducted (n = 80,813) from 185 major emergency hospitals across Japan. The primary outcome variable was in-hospital mortality within 28 days. Secondary outcome variables included serious injuries to different body regions with an Abbreviated Injury Scale of ≥3.
  
  
  RESULTS
  In the analysis of 80,813 trauma patients, males had significantly greater 28-day mortality compared to females (adjusted p = 0.0072, odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.06 to 1.23) via logistic regression analysis adjusted for age, mechanism, Injury Severity Score, Revised Trauma Score, and potential preexisting risk factors. Of 10 injury categories examined, sex significantly affected in-hospital 28-day mortality rate in falls (adjusted p < 0.0001, OR = 1.34, 95% CI = 1.19 to 1.52). Further analysis of three fall subcategories by falling distance revealed that male patients who fell from ground level had significantly higher 28-day mortality (adjusted p < 0.0001, OR = 1.75, 95% CI = 1.43 to 2.14) and a significantly greater frequency of serious injury to the head, thorax, abdomen, and spine, but a lower frequency of serious injury to the extremities, compared to female patients.
  
  
  CONCLUSIONS
  Compared to female trauma patients, male trauma patients had greater 28-day mortality. In particular, ground-level falls had a significant sex difference in mortality, with serious injury to different body regions. Sex differences appeared to be important for fatalities from ground-level falls.
authors.affiliation: The Senshu Trauma and Critical Care Center, Osaka, Japan.|Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Taka-Aki
authors.initials: TA
authors.lastname: Nakada
authors.affiliation: The Senshu Trauma and Critical Care Center, Osaka, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Nakao
authors.affiliation: The Senshu Trauma and Critical Care Center, Osaka, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Mizushima
authors.affiliation: The Senshu Trauma and Critical Care Center, Osaka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Matsuoka
mesh_terms: D000058:Accidental Falls / Q000401:mortality*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution