EM-266---年龄是影响严重创伤患者预后性别差异重要因素-封启明.pdfVIP

年龄是影响严重创伤患者预后性别差异的 重要因素 杨开超 耿磊 朱晓光 仲伟喜 吴蔚 赵钢 封启明* 上海交通大学附属第六人民医院急诊医学科 *通讯作者 封启明 [摘要] 目的 探究不同年龄段严重创伤患者死亡率性别差异的特点，分析年龄因素与 是否是影响创伤预后性别的重要因素。方法 回顾性分析上海交通大学附属上海市第六人民 医院急性创伤急救中EICU 2009年6月-2013年6月收治的成年严重钝性创伤患者，将患者按照 年龄进行分组，比较各组患者预后性别差异的特点。结果 女性创伤患者粗死亡率明显低于 男性（3.7% vs.9.2%, P ＜0.05 ）。在年龄＜30岁 （1.3% vs.6.1%, P ＜0.05 ）及30-39岁 （1.1% vs. 12.7%, P ＜0.05 ）患者中，女性创伤患者死亡率明显低于同龄男性，而在40-49岁（4.1% vs.9.5%, P ＜0.05 ）、50-59岁 （7.7% vs.6.3%, P ＜0.05 ）及年龄＞60岁 （4.7% vs.10.0%, P ＜ 0.05 ）患者中，女性死亡率与同龄男性相比均无明显差异。结论 女性严重创伤患者死亡 率明显低于男性患者，且这种性别差异只存在于年龄＜40的创伤患者中，该结果提示性激素 水平可能是创伤患者预后性别差异的一个重要影响因素。 [关键词] 创伤；损伤严重度；年龄；住院死亡率 Age is a key factor of gender dimorphism in mortality of severe trauma patients Yang KC, Geng L, Zhu XG, Zhong WX, Wu W, Zhao G, Feng QM [Abstract] Objective Our research attempted to characterize sex-based outcome differences after severe blunt trauma , describe the association between age and the sex-based outcome difference of severe trauma patients. Method A retrospective analysis derived from the Emergency Intensive Care Unit of the acute trauma center of Shanghai Sixth People‘s Hospital during the 2009-2013 time period was performed to characterize sex-based outcome differences after severe blunt trauma. The study cohort of patients was then stratified by age. Analyze the association between gender and the hospitalized mortality, both overall and subgroups according to age categories. Results A total of 1288severe trauma patients who meet our inclusion criteria were enrolled in this study. Crude mortality was higher for males in severe trauma patients (male 5.0% vs. female 9.1%, p 0.05). In age subgroup ，male have a significantly higher morality than female in patients age less than 40 years old, but here is no significant difference between genders in mortality of trauma patients age greater than 40 years. Conclusions The present study revealed a statistical significant association between gender and mort