Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, WI, United States.
Division of Trauma and Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States.
Front Public Health. 2024 Mar 15;12:1331313. doi: 10.3389/fpubh.2024.1331313. eCollection 2024.
Multiple studies evaluate relative risk of female vs. male crash injury; clinical data may offer a more direct injury-specific evaluation of sex disparity in vehicle safety. This study sought to evaluate trauma injury patterns in a large trauma database to identify sex-related differences in crash injury victims.
Data on lap and shoulder belt wearing patients age 16 and up with abdominal and pelvic injuries from 2018 to 2021 were extracted from the National Trauma Data Bank for descriptive analysis using injuries, vital signs, International Classification of Disease (ICD) coding, age, and injury severity using AIS (Abbreviated Injury Scale) and ISS (Injury Severity Score). Multiple linear regression was used to assess the relationship of shock index (SI) and ISS, sex, age, and sexage interaction. Regression analysis was performed on multiple injury regions to assess patient characteristics related to increased shock index.
Sex, age, and ISS are strongly related to shock index for most injury regions. Women had greater overall SI than men, even in less severe injuries; women had greater numbers of pelvis and liver injuries across severity categories; men had greater numbers of injury in other abdominal/pelvis injury regions.
Female crash injury victims' tendency for higher (AIS) severity of pelvis and liver injuries may relate to how their bodies interact with safety equipment. Females are entering shock states (SI > 1.0) with lesser injury severity (ISS) than male crash injury victims, which may suggest that female crash patients are somehow more susceptible to compromised hemodynamics than males. These findings indicate an urgent need to conduct vehicle crash injury research within a sex-equity framework; evaluating sex-related clinical data may hold the key to reducing disparities in vehicle crash injury.
多项研究评估了女性与男性碰撞受伤的相对风险；临床数据可能为车辆安全性别差异提供更直接的损伤特异性评估。本研究旨在通过评估大型创伤数据库中的创伤模式，确定车祸受伤者的性别相关差异。
从国家创伤数据库中提取了 2018 年至 2021 年间年龄在 16 岁及以上、有腹部和骨盆损伤且系着安全带（包括腰部安全带和肩部安全带）的患者数据，用于描述性分析，分析指标包括损伤、生命体征、国际疾病分类（ICD）编码、年龄和 AIS（简明损伤评分）和 ISS（损伤严重程度评分）。采用多元线性回归评估休克指数（SI）和 ISS、性别、年龄和性别年龄交互作用与损伤的关系。对多个损伤区域进行回归分析，评估与增加休克指数相关的患者特征。
性别、年龄和 ISS 与大多数损伤区域的休克指数密切相关。女性的总体 SI 高于男性，即使在损伤较轻的情况下也是如此；女性在所有严重程度类别中骨盆和肝脏损伤的数量都较多；男性在其他腹部/骨盆损伤区域的损伤数量较多。
女性车祸受伤者骨盆和肝脏损伤（AIS）严重程度较高的趋势可能与她们的身体与安全设备的相互作用有关。女性在受伤严重程度（ISS）低于男性车祸受伤者的情况下出现休克状态（SI>1.0），这可能表明女性车祸患者在某种程度上比男性更容易出现血流动力学受损。这些发现表明迫切需要在性别平等框架内进行车辆碰撞损伤研究；评估与性别相关的临床数据可能是减少车辆碰撞损伤差异的关键。
