title: Influence of gender on systemic IL-6 levels, complication rates and outcome after major trauma.
abstract: While female gender was associated with lower rates of systemic inflammatory response syndrome (SIRS), sepsis and single and/or multiple organ failure (MOF), contradictory data suggest no correlation between gender and complication rates and/or outcome in trauma patients (TP). Here, we analyzed the gender influence on systemic interleukin (IL)-6 levels and outcome in TP.
  
  
  
  343 TP with injury severity scores (ISS) ≥16 were included upon admittance to the emergency department (ED) and grouped to male (n=257) vs. female (n=86). Injury severity, vital signs, physiological parameters, length of intensive care unit (ICU) and in-hospital stay, outcome parameters including SIRS, sepsis, respiratory complications, single- and/or MOF and in-hospital mortality were analyzed. Systemic IL-6 levels during the first 10 post-injury days were determined daily.
  
  
  
  Age (45.0±1.0 vs. 48.2±2.1) and ISS (27.1±0.8 vs. 24.7±1.2) were comparable between both groups. Abbreviated Injury Scale (AIS) ≥3 of chest and abdominal body regions were significantly higher in male TP (chest:51.02% vs. 36.05%, abdomen:19.84% vs. 10.47%, p<0.05). IL-6 was significantly increased in male TP on post-injury days 1 and 2 (d1:363.9±72.58 vs. 163.7±25.98; d2:194.3±31.38 vs. 114.3±17.81pg/ml, p<0.05). Multivariate analysis excluded an association of increased chest or abdominal injury occurrence with IL-6 levels. Female vs. male TP had significantly lower SIRS and sepsis occurrence (SIRS:40.70% vs. 53.31%, sepsis:6.98% vs. 19.46%, p<0.05). There were no gender-based differences regarding ICU or in-hospital stay, single and/or MOF and respiratory complications.
  
  
  
  Taken together, higher systemic IL-6 levels after trauma are associated with enhanced susceptibility for SIRS and sepsis in male patients.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Mörs
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Olivia
authors.initials: O
authors.lastname: Braun
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Wagner
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Auner
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Maika
authors.initials: M
authors.lastname: Voth
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Störmann
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wutzler
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Marzi
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany. Electronic address: info@bornarelja.com.
authors.forename: Borna
authors.initials: B
authors.lastname: Relja
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood* / Q000276:immunology; D018805:Sepsis / Q000097:blood* / Q000276:immunology; D012727:Sex Characteristics; D014947:Wounds and Injuries / Q000097:blood* / Q000276:immunology
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6
keywords: Gender; IL-6; Outcome; SIRS; Sepsis; Trauma