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Abstract
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BACKGROUND: Several studies have identified gender as a factor influencing early outcomes after trauma. With the increased representation of women in combat roles, there is a need for improved understanding of the pathophysiology of traumatic injury in females. The purpose of this study was to define sex-based differences in early combat trauma outcomes amongst military service members.
METHODS: A retrospective review of the Department of Defense Trauma Registry (DoDTR) between 2008 and 2016 was performed. A 2:1 case control match was performed to match for injury severity score (ISS), mechanism of injury, and age. The primary outcome of the study was mortality.
RESULTS: A total of 4625 patients were included in the study, 2.2% of whom were women. Females were less significantly injured than males (ISS 7.7 vs 11, p=0.003) and more likely to sustain blunt trauma (81% v 62.5%, p=0.01). After case control matching, 202 males and 101 females were evaluated. There was no statistical difference in the primary outcome of mortality. There was no statistical difference in GCS, crystalloid or colloid administration, PRBC, platelet, cryoprecipitate, or plasma usage between men and women.
CONCLUSIONS: Contrary to the civilian trauma literature, our study demonstrated no significant difference in early mortality between male and female combat casualties in a matched cohort. This finding may represent a difference in injury patterns, resuscitation practices, or lifesaving interventions in a deployed setting as compared to civilian setting. As the proportion of females involved in combat operations continues to increase, prospective studies should be performed to better define injury patterns, as well as early and late outcomes related to military trauma in the female population. LEVEL OF EVIDENCE: Level IV STUDY TYPE: Retrospective.
Language: en |