Female risk-adjusted survival advantage after injuries caused by falls, traffic or assault: a nationwide 11-year study.


Journal

Scandinavian journal of trauma, resuscitation and emergency medicine
ISSN: 1757-7241
Titre abrégé: Scand J Trauma Resusc Emerg Med
Pays: England
ID NLM: 101477511

Informations de publication

Date de publication:
15 Mar 2019
Historique:
received: 21 09 2018
accepted: 06 02 2019
entrez: 16 3 2019
pubmed: 16 3 2019
medline: 8 5 2019
Statut: epublish

Résumé

A female survival advantage after injury has been observed, and animal models of trauma have suggested either hormonal or genetic mechanisms as component causes. Our aim was to compare age and risk-adjusted sex-related mortality in hospital for the three most common mechanisms of injury in relation to hormonal effects as seen by age. All hospital admissions for injury in Sweden during the period 2001-2011 were retrieved from the National Patient Registry and linked to the Cause of Death Registry. The International Classification of Diseases Injury Severity Score (ICISS) was used to adjust for injury severity, and the Charlson Comorbidity Index to adjust for comorbidity. Age categories (0-14, 15-50, and ≥ 51 years) were used to represent pre-menarche, reproductive and post- menopausal women. Women had overall a survival benefit (OR 0.51; 95% CI 0.50 to 0.53) after adjustment for injury severity and comorbidity. A similar pattern was seen across the age categories (0-14 years OR 0.56 (95% CI 0.25 to 1.25), 15-50 years OR 0.70 (95% CI 0.57 to 0.87), and ≥ 51 years OR 0.49 (95% CI 0.48 to 0.51)). In this 11-year population-based study we found no support for an oestrogen-related mechanism to explain the survival advantage for females compared to males following hospitalisation for injury.

Sections du résumé

BACKGROUND BACKGROUND
A female survival advantage after injury has been observed, and animal models of trauma have suggested either hormonal or genetic mechanisms as component causes. Our aim was to compare age and risk-adjusted sex-related mortality in hospital for the three most common mechanisms of injury in relation to hormonal effects as seen by age.
METHODS METHODS
All hospital admissions for injury in Sweden during the period 2001-2011 were retrieved from the National Patient Registry and linked to the Cause of Death Registry. The International Classification of Diseases Injury Severity Score (ICISS) was used to adjust for injury severity, and the Charlson Comorbidity Index to adjust for comorbidity. Age categories (0-14, 15-50, and ≥ 51 years) were used to represent pre-menarche, reproductive and post- menopausal women.
RESULTS RESULTS
Women had overall a survival benefit (OR 0.51; 95% CI 0.50 to 0.53) after adjustment for injury severity and comorbidity. A similar pattern was seen across the age categories (0-14 years OR 0.56 (95% CI 0.25 to 1.25), 15-50 years OR 0.70 (95% CI 0.57 to 0.87), and ≥ 51 years OR 0.49 (95% CI 0.48 to 0.51)).
CONCLUSION CONCLUSIONS
In this 11-year population-based study we found no support for an oestrogen-related mechanism to explain the survival advantage for females compared to males following hospitalisation for injury.

Identifiants

pubmed: 30871611
doi: 10.1186/s13049-019-0597-3
pii: 10.1186/s13049-019-0597-3
pmc: PMC6419337
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

24

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Auteurs

Robert Larsen (R)

Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden. robert.larsen@liu.se.
Department of Anaesthesiology and Intensive Care, and Department of Medical and Health Sciences, Linkoping University, S-58185, Linkoping, Sweden. robert.larsen@liu.se.
Department of Hand Surgery, Plastic Surgery and Burns, and Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden. robert.larsen@liu.se.

Denise Bäckström (D)

Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden.
Life Regiment Hussars, K3, Karlsborg, Sweden.

Mats Fredrikson (M)

Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden.

Ingrid Steinvall (I)

Department of Hand Surgery, Plastic Surgery and Burns, and Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden.

Rolf Gedeborg (R)

Department of Surgical Sciences, Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.

Folke Sjoberg (F)

Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden.
Department of Anaesthesiology and Intensive Care, and Department of Medical and Health Sciences, Linkoping University, S-58185, Linkoping, Sweden.
Department of Hand Surgery, Plastic Surgery and Burns, and Department of Clinical and Experimental Medicine, Linkoping University, Linkoping, Sweden.

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