title: 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.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany. carsten.schoeneberg@krupp-krankenhaus.de.
authors.forename: Carsten
authors.identifier: http://orcid.org/0000-0001-5633-1616
authors.initials: C
authors.lastname: Schoeneberg
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany. daniel.schmitz@krupp-krankenhaus.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schmitz
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany. sandra.schoeneberg82@googlemail.com.
authors.forename: Sandra
authors.initials: S
authors.lastname: Schoeneberg
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany. bjoern.hussmann@krupp-krankenhaus.de.
authors.forename: Björn
authors.initials: B
authors.lastname: Hussmann
authors.affiliation: Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany. sven.lendemans@krupp-krankenhaus.de.
authors.forename: Sven
authors.initials: S
authors.lastname: Lendemans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005858:Germany; D015600:Glasgow Coma Scale; D006403:Hematologic Tests / Q000379:methods*; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D011237:Predictive Value of Tests; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016019:Survival Analysis; D014193:Trauma Centers
keywords: Gender-specific laboratory values; Gender-specific therapy; Lactate; Mortality rate predictors; Severe trauma