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Long-term follow-up finds gender differences in recovery from multiple trauma

Women had a greater incidence of post-traumatic stress disorder; men experienced more depression

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BOSTON — Research has indicated that because of hormonal differences, pre-menopausal women may be better protected from severe post-traumatic inflammatory reactions after multiple trauma in the acute phase than men. However, new research has indicated that in the long-term, women may be more susceptible to the psychological consequences of multiple trauma than their male counterparts.

In an attempt to see if gender makes a difference in the long-term outcomes after multiple-trauma injuries, Christian Probst, MD, and colleagues at Hanover Medical School, in Hanover, Germany, and the University of Pittsburgh investigated 637 polytrauma patients treated at a Level 1 trauma center with at least 10 years of follow-up.

Probst presented the results at the 23rd Annual Meeting of the Orthopaedic Trauma Association, held here.

"Participating patients were examined by a trauma surgeon and completed an extensive questionnaire comprising specialized outcomes scores for physical and mental outcomes," he said.

The study group included 158 women and 479 men, with no significant differences between the gender groups for age at injury, length of follow-up, number of injuries or diagnoses, Probst said.

"Looking at rehabilitation treatment, women [required] longer rehabilitation times ... and women took longer leaves from their jobs," he said. However, both sexes had nearly equal satisfaction with their outcomes, he noted.

Data from the study showed that, at 17 years mean follow-up, women required more psychological support — 28% of women vs. 15% of men. Women also had a higher incidence of post-traumatic stress disorder — 14.5% of women vs. 6.2% of men — but men reported more episodes of depression, 24.1% vs. 15.4% of women.

"We think that all health systems and participating doctors should more frequently offer psychological support to multiple-trauma patients," Probst said.

For more information:

• Probst C, Zelle B, Panzica M, et al. Long-term outcome assessment after trauma: Does gender play a role? Paper #10. Presented at the 23rd Annual Meeting of the Orthopaedic Trauma Association. Oct. 18-20. Boston.
• The study was supported by a grant from Hanover RE Insurances.