A multicenter evaluation of whether gender dimorphism affects survival after trauma

Am J Surg. 2001 Apr;181(4):297-300. doi: 10.1016/s0002-9610(01)00582-7.


Background: The frequency of women who have sustained severe injuries has increased over the past 30 years. The purpose of this study was to evaluate whether severely injured women have a survival advantage over men. To address this issue, we undertook a multicenter evaluation of the effects of gender dimorphism on survival in trauma patients.

Methods: Patient information was collected from the databases of three level 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, gender, 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 centers. Women who were younger than 50 years of age (mortality rate 5%) experienced a survival advantage over men (mortality rate 7%) of equal age (odds ratio 1.27, P <0.002). This advantage was most notably found in the more severely injured (ISS >25) group (mortality rate 28% in women versus 33% in men). This difference was not attributable to mechanism of injury, severity of injury, or pattern of injury.

Conclusions: Severely injured women younger than 50 years of age have a survival advantage when compared with men of equal age and injury severity. Young men have a 27% greater chance of dying than women after trauma. We conclude that gender dimorphism affects the survival of patients after trauma.

Publication types

  • Multicenter Study

MeSH terms

  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Sex Characteristics*
  • Survival Rate
  • Trauma Severity Indices
  • Wounds and Injuries / mortality*
  • Wounds, Nonpenetrating / mortality
  • Wounds, Penetrating / mortality