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Acad Emerg Med. 2015 Jun;22(6):708-13. doi: 10.1111/acem.12677. Epub 2015 May 20.

Association between male sex and increased mortality after falls.

Author information

1
The Senshu Trauma and Critical Care Center, Osaka, Japan.
2
Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.

Abstract

OBJECTIVES:

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.

PMID:
25996880
DOI:
10.1111/acem.12677
[Indexed for MEDLINE]
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