Burns Aliya G, Leonard Matthew, Collins Hannah, Burns Bracken
Surgery, East Tennessee State University Quillen College of Medicine, Johnson City, USA.
Trauma, Ballad Health, Johnson City, USA.
Cureus. 2025 May 18;17(5):e84347. doi: 10.7759/cureus.84347. eCollection 2025 May.
Although men are more likely to experience a traumatic injury, research demonstrates that gender may impact patients' biological responses to trauma. Shock index (SI) is a validated tool used to predict patient outcomes. This study aims to determine if gender is associated with differences in outcomes in patients with an SI ≥1.0 in the rural setting.
This retrospective study included 699 trauma patients with an SI ≥1.0 admitted to a rural trauma center from January 2017 to December 2022. Student's t-test, chi-square analysis, and univariate logistic regression were used to analyze the study data. Primary outcomes included mortality and blood transfusions. Secondary outcomes included discharge to a care facility, hospital days, ICU days, and ventilator days.
Males with a SI ≥1.0 had a significantly longer length of stay (LOS) (7.0 ± 7.4 vs. 5.8 ± 6.7, P = 0.039), had a higher injury severity score (14.5 ± 12.2 vs. 10.4 ± 10.1, P < 0.001), were x1.99 more likely to die (OR = 1.999, 95% CI = 0.213-1.171, P = 0.005), and were x1.7 more likely to require blood transfusion (OR = 1.700, 95% CI = 0.323-0.937, P = 0.002) than females. Males were 4.4 times more likely to have a motorcycle accident (OR = 4.4, 95% CI = 1.935-9.816, P < 0.001). Females were 1.5 times more likely to have a fall (OR = 1.5, 95% CI = 1.099-2.146, P = 0.012) and 1.6 times more likely to have an MVC (OR = 1.6, 95% CI = 1.141-2.175, P = 0.006).
These findings emphasize a gender disparity in trauma patients with an SI ≥1.0 at this study's rural institution. This study adds to the literature on SI and gender disparities.
尽管男性更容易遭受创伤性损伤，但研究表明，性别可能会影响患者对创伤的生物学反应。休克指数（SI）是一种经过验证的用于预测患者预后的工具。本研究旨在确定在农村地区，性别是否与SI≥1.0的患者的预后差异相关。
这项回顾性研究纳入了2017年1月至2022年12月期间入住农村创伤中心的699例SI≥1.0的创伤患者。采用学生t检验、卡方分析和单因素逻辑回归分析研究数据。主要结局包括死亡率和输血情况。次要结局包括转至护理机构、住院天数、重症监护病房（ICU）天数和呼吸机使用天数。
SI≥1.0的男性患者住院时间显著更长（7.0±7.4天 vs. 5.8±6.7天，P = 0.039），损伤严重程度评分更高（14.5±12.2 vs. 10.4±10.1，P < 0.001），死亡可能性高1.99倍（OR = 1.999，95% CI = 0.213 - 1.171，P = 0.005），输血需求可能性高1.7倍（OR = 1.700，95% CI = 0.323 - 0.937，P = 0.002）。男性发生摩托车事故的可能性高4.4倍（OR = 4.4，95% CI = 1.935 - 9.816，P < 0.001）。女性跌倒的可能性高1.5倍（OR = 1.5，95% CI = 1.099 - 2.146，P = 0.012），发生机动车碰撞事故（MVC）的可能性高1.6倍（OR = 1.6，95% CI = 1.141 - 2.175，P = 0.006）。
这些发现强调了在本研究的农村机构中，SI≥1.0的创伤患者存在性别差异。本研究补充了关于SI和性别差异的文献。
