TY - JOUR
T1 - Clinical re-examination 10 or more years after polytrauma
T2 - Is there a gender related difference?
AU - Probst, Christian
AU - Zelle, Boris
AU - Panzica, Martin
AU - Lohse, Ralf
AU - Sitarro, Nicola Alexander
AU - Krettek, Christian
AU - Pape, Hans Christoph
PY - 2010/3
Y1 - 2010/3
N2 - 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.
AB - 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.
KW - Gender
KW - Long-term
KW - Outcome
KW - Trauma
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U2 - 10.1097/TA.0b013e3181a8b21c
DO - 10.1097/TA.0b013e3181a8b21c
M3 - Article
C2 - 19996800
AN - SCOPUS:77949449528
SN - 0022-5282
VL - 68
SP - 706
EP - 711
JO - Journal of Trauma - Injury, Infection and Critical Care
JF - Journal of Trauma - Injury, Infection and Critical Care
IS - 3
ER -