Do male and female trauma patients receive the same prehospital care?: an observational follow-up study

Rebecka Rubenson Wahlin,Markus Skrivfars,Hanna Lövbrand,Hans Morten Lossius,Maaret Castrén,Sari Ponzer

doi:10.1186/s12873-016-0070-9

Abstract

BackgroundTrauma-related mortality can be lowered by efficient prehospital care. Less is known about whether gender influences the prehospital trauma care provided. The aim of this study was to explore gender-related differences in prehospital trauma care of severely injured trauma patients, with a special focus on triage, transportation, and interventions.MethodsWe performed a retrospective observational study based on local trauma registries and hospital and ambulance records in Stockholm County, Sweden. A total of 383 trauma patients (279 males and 104 females) > 15 years of age with an Injury Severity Score (ISS) of > 15 transported to emergency care hospitals in the Stockholm area were included.ResultsMale patients had a 2.75 higher odds ratio (95 % CI, 1.2–6.2) for receiving the highest prehospital priority compared to females on controlling for injury mechanism and vital signs on scene. No significant difference between genders was detected regarding other aspects of the prehospital care provided.ConclusionsThis study indicated that prehospital prioritization among severely injured late adolescent and adult trauma patients differs between genders. Knowledge of a more diffuse presentation of symptoms in female trauma patients despite severe injury may help to adapt and improve prehospital trauma care for this group.

Highlights

Trauma-related mortality can be lowered by efficient prehospital care
The Stockholm County Council (SCC) has the overall responsibility for all healthcare, including the emergency medical services (EMS) and the seven emergency care hospitals, one of which has two sites, but only one of them can be regarded as a level-1 trauma center according to the American College of Surgeons’ criteria [14]
Female gender was significantly more frequent among patients with self-inflicted injuries, while males were more often exposed to assaults (p = 0.041)

Summary

Introduction

Trauma-related mortality can be lowered by efficient prehospital care. Less is known about whether gender influences the prehospital trauma care provided. The aim of this study was to explore gender-related differences in prehospital trauma care of severely injured trauma patients, with a special focus on triage, transportation, and interventions. Some studies have suggested differences between genders in terms of type and severity of trauma, the prehospital care provided, and outcome. Wohltmann and colleagues showed that young males have a 27 % higher risk of dying from trauma compared to females [5]. These findings were supported by a Swedish study reporting males to have an increased risk of 1-year mortality even when adjusted for injury severity and other probable confounders [6]. Gomez et al reported that severely injured females are less likely to be directed to a trauma center [8]

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