Clinical re-examination 10 or more years after polytrauma: Is there a gender related difference?

Christian Probst, Boris Zelle, Martin Panzica, Ralf Lohse, Nicola Alexander Sitarro, Christian Krettek, Hans Christoph Pape

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

BACKGROUND: Previous studies documented that premenopausal women better tolerate severe injuries than men in regards to mortality and intensive care complications. We test the hypothesis whether surviving women have a better long-term outcome than surviving men. METHODS: We reassessed 637 polytrauma patients 10 or more years (mean 17 ± 5 years) after trauma. Mental health was assessed by the posttraumatic stress diagnostic scale and the Hospital Anxiety and Depression Scale. The clinical outcome was assessed by standardized scores (Hannover Score for Polytrauma Outcome and short form-12). A physical examination was performed by an orthopedic surgeon. RESULTS: We studied 479 men (M; 75.4%) and 158 women (F; 24.6%) aged M = 26.7 ± 12.2 versus F = 25.9 ± 13.0 years (p = 0.47). Injury Severity Score showed M = 20.4 ± 9.9 versus F = 21.7 ± 9.7 (p = 0.13). Women showed a higher rate of posttraumatic stress disorder (F = 14.5% vs. M = 6.2%; p = 0.035) and psychologic support (F = 28.0% vs. M = 15.0%; p < 0.001), longer duration of rehabilitation, and longer sick leave time. Quality-of-life was significantly lower in women (Short form-12 psychologic F = 48.6 ± 10.8 vs. M = 50.8 ± 9.4; p = 0.02), but the same rate of women (75.3%) and men (75.4%; p = 0.995) felt well rehabilitated. CONCLUSION: Late after polytrauma, women suffer more severe psychologic impairment than men who had similar injuries. This finding is independent of physical impairment and the subjective feeling of a good rehabilitation outcome. Clinically, women require special support even years after injury to improve their psychologic status. In the future, they might benefit from early concomitant psychologic treatment if mental problems are suspected.

Original languageEnglish (US)
Pages (from-to)706-711
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume68
Issue number3
DOIs
StatePublished - Mar 2010
Externally publishedYes

Keywords

  • Gender
  • Long-term
  • Outcome
  • Trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

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