Gender-based trauma outcomes and predictors of postinjury in-hospital mortalities: A multicenter analysis from the national trauma registry of Iran

Abstract

Background and Objectives: Injuries in countries like Iran are one of the leading causes of death. This study aims to determine gender differences in trauma outcomes and predictors of in-hospital mortality after trauma. Methods: The data of four trauma centers were extracted from the National Trauma Registry of Iran databank between 2016 and 2020. The univariable and multiple logistic regression models analyzed gender differences in trauma outcomes and postinjury predictors of in-hospital mortalities. Results: Among 17,530 patients, the most common cause of injury in both genders was road traffic injury (40%). Regarding in-hospital mortality after trauma, although there was a significant gender-based difference between some centers, no overall gender difference was seen (0.9% vs. 1.0% P = 0.26). The odds of in-hospital mortality for patients over 65 years old was 10.45 times more than that for patients under 15 years old. Furthermore, the odds of in-hospital mortality for patients admitted to intensive care units (ICU) was 6.22 times as high as that for patients who were not admitted to ICUs. Intubation status had a significant association with in-hospital mortality after adjustment for covariates. The odds of in-hospital mortality for patients with an injury severity score (ISS) ≥16 was 2.57 times higher than that for patients with ISS 1–8. Conclusions: Although males had a survival privilege over females following trauma in some centers, there was no overall association between gender and in-hospital mortality. Moreover, older age, ISS, ICU admission, and intubation were predictors of in-hospital mortality for trauma.