Association Between Male Sex and Increased Mortality After Falls

• Published in: Academic emergency medicine Vol. 22; no. 6; pp. 708 - 713
• Main Authors: Nakada, Taka‐aki, Nakao, Shota, Mizushima, Yasuaki, Matsuoka, Tetsuya, Byyny, Richard
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.06.2015
• Subjects: Accidental Falls - mortality; Adult; Aged; Aged, 80 and over; Databases, Factual; Falls; Female; Gender differences; Hospital Mortality; Humans; Injury Severity Score; Japan; Logistic Models; Male; Middle Aged; Mortality; Odds Ratio; Regression analysis; Retrospective Studies; Risk Factors; Sex Distribution; Trauma; Japan
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/acem.12677

Objectives Whether sex affects the mortality of trauma patients remains unknown. The hypothesis of this study was that sex was associated with altered mortality rates in trauma. Methods A retrospective review of trauma patients’ records in the Japan Trauma Data Bank was conducted (n = 80,813) from 185 major emergency hospitals across Japan. The primary outcome variable was in‐hospital mortality within 28 days. Secondary outcome variables included serious injuries to different body regions with an Abbreviated Injury Scale of ≥3. Results In the analysis of 80,813 trauma patients, males had significantly greater 28‐day mortality compared to females (adjusted p = 0.0072, odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.06 to 1.23) via logistic regression analysis adjusted for age, mechanism, Injury Severity Score, Revised Trauma Score, and potential preexisting risk factors. Of 10 injury categories examined, sex significantly affected in‐hospital 28‐day mortality rate in falls (adjusted p < 0.0001, OR = 1.34, 95% CI = 1.19 to 1.52). Further analysis of three fall subcategories by falling distance revealed that male patients who fell from ground level had significantly higher 28‐day mortality (adjusted p < 0.0001, OR = 1.75, 95% CI = 1.43 to 2.14) and a significantly greater frequency of serious injury to the head, thorax, abdomen, and spine, but a lower frequency of serious injury to the extremities, compared to female patients. Conclusions Compared to female trauma patients, male trauma patients had greater 28‐day mortality. In particular, ground‐level falls had a significant sex difference in mortality, with serious injury to different body regions. Sex differences appeared to be important for fatalities from ground‐level falls.