Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors

Abstract Background Trauma is a leading cause of mortality, particularly in low and middle-income countries. While extensively studied in North America and Europe, data from the Asia-Pacific are limited. An important area of research is the difference in trauma outcomes, which are theoretically note...

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Main Authors: Mohamad Iqhbal Bin Kunji Mohamad, Sabariah Faizah Jamaluddin, Norhaiza Ahmad, Arifah Bahar, Zarina Mohd Khalid, Nuraina Aqilah Binti Mohd Zaki, Nurul Azlean Norzan, Sang Do Shin, Goh E. Shaun, Wen-Chu Chiang, Kentaro Kajino, Kyoung Jun Song, Do Ngoc Son
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s13049-025-01342-1
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author Mohamad Iqhbal Bin Kunji Mohamad
Sabariah Faizah Jamaluddin
Norhaiza Ahmad
Arifah Bahar
Zarina Mohd Khalid
Nuraina Aqilah Binti Mohd Zaki
Nurul Azlean Norzan
Sang Do Shin
Goh E. Shaun
Wen-Chu Chiang
Kentaro Kajino
Kyoung Jun Song
Do Ngoc Son
author_facet Mohamad Iqhbal Bin Kunji Mohamad
Sabariah Faizah Jamaluddin
Norhaiza Ahmad
Arifah Bahar
Zarina Mohd Khalid
Nuraina Aqilah Binti Mohd Zaki
Nurul Azlean Norzan
Sang Do Shin
Goh E. Shaun
Wen-Chu Chiang
Kentaro Kajino
Kyoung Jun Song
Do Ngoc Son
author_sort Mohamad Iqhbal Bin Kunji Mohamad
collection DOAJ
description Abstract Background Trauma is a leading cause of mortality, particularly in low and middle-income countries. While extensively studied in North America and Europe, data from the Asia-Pacific are limited. An important area of research is the difference in trauma outcomes, which are theoretically noted to be better among females. However, the clinical findings are inconclusive among Asians. This study examines sex-based differences in trauma outcomes in Asia Pacific, focusing on in-hospital mortality and functional recovery at discharge. Methods This observational study, from the Pan-Asia Trauma Outcomes Study (PATOS), included 76,645 trauma patients from 12 Asian Pacific countries. We analysed in-hospital mortality and functionality at discharge using the Glasgow Outcome Scale (GOS) and the modified Rankin Scale (mRS). Logistic regression models were built to test the association of sex on the outcomes. Results Males exhibited higher in-hospital mortality (1.6%) compared to females (1.06%) ( p < 0.001). Adjusted logistic regression models showed that the female sex is not independently associated with in-hospital mortality. Females have a better functional outcome at discharge for patients younger than 50 years with ISS < 16. However, no significant differences existed between those > 50 years and ISS > 15. Conclusion This study indicates no difference in the general trauma outcomes in the Asia Pacific between females and males. Although younger females with less severe injuries had better functional outcomes, this advantage disappeared in severe injuries and those over 50 years. These results align with some previous studies, and understanding the nuances may lead to more tailored trauma care, potentially improving patient outcomes.
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publishDate 2025-02-01
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series Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
spelling doaj-art-a86d816e87b04c36b7639e65bd98c1872025-08-20T03:41:47ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-02-0133111010.1186/s13049-025-01342-1Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factorsMohamad Iqhbal Bin Kunji Mohamad0Sabariah Faizah Jamaluddin1Norhaiza Ahmad2Arifah Bahar3Zarina Mohd Khalid4Nuraina Aqilah Binti Mohd Zaki5Nurul Azlean Norzan6Sang Do Shin7Goh E. Shaun8Wen-Chu Chiang9Kentaro Kajino10Kyoung Jun Song11Do Ngoc Son12Faculty of Medicine, Universiti Teknologi MARA, UITM Sungai Buloh Campus, Jalan HospitalFaculty of Medicine, Universiti Teknologi MARA, UITM Sungai Buloh Campus, Jalan HospitalDepartment of Mathematical Sciences, Faculty of Science, Universiti Teknologi MalaysiaUTM-Centre for Industrial and Applied Mathematics, Universiti Teknologi MalaysiaDepartment of Mathematical Sciences, Faculty of Science, Universiti Teknologi MalaysiaDepartment of Mathematical Sciences, Faculty of Science, Universiti Teknologi MalaysiaEmergency and Trauma Department, Sungai Buloh HospitalDepartment of Emergency Medicine, Seoul National University College of Medicine and HospitalEmergency Department, Woodlands Health CampusDepartment of Emergency Medicine, National Taiwan University HospitalDepartment of Emergency and Critical Care Medicine, Kansai Medical UniversityDepartment of Emergency Medicine, Seoul National University Boramae Medical CenterCenter for Emergency Medicine, Bach Mai HospitalAbstract Background Trauma is a leading cause of mortality, particularly in low and middle-income countries. While extensively studied in North America and Europe, data from the Asia-Pacific are limited. An important area of research is the difference in trauma outcomes, which are theoretically noted to be better among females. However, the clinical findings are inconclusive among Asians. This study examines sex-based differences in trauma outcomes in Asia Pacific, focusing on in-hospital mortality and functional recovery at discharge. Methods This observational study, from the Pan-Asia Trauma Outcomes Study (PATOS), included 76,645 trauma patients from 12 Asian Pacific countries. We analysed in-hospital mortality and functionality at discharge using the Glasgow Outcome Scale (GOS) and the modified Rankin Scale (mRS). Logistic regression models were built to test the association of sex on the outcomes. Results Males exhibited higher in-hospital mortality (1.6%) compared to females (1.06%) ( p < 0.001). Adjusted logistic regression models showed that the female sex is not independently associated with in-hospital mortality. Females have a better functional outcome at discharge for patients younger than 50 years with ISS < 16. However, no significant differences existed between those > 50 years and ISS > 15. Conclusion This study indicates no difference in the general trauma outcomes in the Asia Pacific between females and males. Although younger females with less severe injuries had better functional outcomes, this advantage disappeared in severe injuries and those over 50 years. These results align with some previous studies, and understanding the nuances may lead to more tailored trauma care, potentially improving patient outcomes.https://doi.org/10.1186/s13049-025-01342-1Trauma mortalityAsian femalesGlasgow outcome scaleModified Rankin’s scaleTrauma in-hospital mortalityTrauma sex differences
spellingShingle Mohamad Iqhbal Bin Kunji Mohamad
Sabariah Faizah Jamaluddin
Norhaiza Ahmad
Arifah Bahar
Zarina Mohd Khalid
Nuraina Aqilah Binti Mohd Zaki
Nurul Azlean Norzan
Sang Do Shin
Goh E. Shaun
Wen-Chu Chiang
Kentaro Kajino
Kyoung Jun Song
Do Ngoc Son
Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Trauma mortality
Asian females
Glasgow outcome scale
Modified Rankin’s scale
Trauma in-hospital mortality
Trauma sex differences
title Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
title_full Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
title_fullStr Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
title_full_unstemmed Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
title_short Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors
title_sort trauma outcomes differences in females a prospective analysis of 76 000 trauma patients in the asia pacific region and the contributing factors
topic Trauma mortality
Asian females
Glasgow outcome scale
Modified Rankin’s scale
Trauma in-hospital mortality
Trauma sex differences
url https://doi.org/10.1186/s13049-025-01342-1
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