A multicenter evaluation of whether gender dimorphism affects survival after trauma

Background: The frequency of women who have sustained severe injuries has i ncreased over the past 30 years. The purpose of this study was to evaluate whether severely injured women have a survival advantage over men. To addre ss this issue, we undertook a multicenter evaluation of the effects of gend er dimorphism on survival in trauma patients. Methods: Patient information was collected from the databases of three leve l I trauma centers. We included all consecutive patients who were admitted to these centers over a 4-year period. We evaluated the effects of age, gen der, mechanism of injury, pattern of injury, Abbreviated Injury Score (AIS) , and Injury Severity Score (ISS) on survival. Results: A total of 20,261 patients were admitted to the three trauma cente rs. Women who were younger than 50 years of age (mortality rate 5%) experie nced a survival advantage over men (mortality rate 7%) of equal age (odds r atio 1.27, P <0.002). This advantage was most notably found in the more sev erely injured (ISS >25) group (mortality rate 28% in women versus 33% in me n). This-difference was not attributable to mechanism of injury, severity o f injury, or pattern of injury. Conclusions: Severely injured women younger than 50 years of age have a sur vival advantage when compared with men of equal age and injury severity. Yo ung men have a 27% greater chance Of dying than women after trauma. We conc lude that gender dimorphism affects the survival of patients after trauma. (C) 2001 Excerpta Medica, Inc. All rights reserved.