Gender-Specific Improvements in Outcome 1 and 2 Years After Major Trauma

Abstract

BackgroundThe study aim was to evaluate patient progress over time, given the limited knowledge available on gender-dependent longer-term outcomes after major trauma. Materials and methodsThis is a prospective longitudinal survey of consecutive trauma survivors with a New Injury Severity Score ≥8, comparing working capacity and outcome scores of male versus female patients at 1- and 2-y follow-ups (trauma medical outcomes study Short Form-36, Euro Quality of Life [EuroQoL], Glasgow Outcome Scale [GOS]; mean + standard deviation; univariate analysis [Pearson’s r]; P < 0.05). ResultsA total of 335 major trauma patients (71% male; aged 54.8 ± 18.8 y; New Injury Severity Score 18.6 ± 9.3) participated at both follow-up time points. Overall, a significant improvement in patients’ working capacity was found (P < 0.001) in the second year after trauma compared with 1 y earlier. At 2 y, 24% of working patients were still suffering from a diminished capacity to work. Improvements in working capacity correlated only weakly with outcome scores; best in the GOS (r = 0.23) and the EuroQol (r = 0.22). Women, but not men, demonstrated a significant improvement in quality of life (QoL) over time: to a higher level, for example, on the GOS (P = 0.001), the EuroQoL (P = 0.018), and the physical component of the Short Form-36 (P = 0.05). ConclusionsThis longitudinal longer-term follow-up found an overall improvement in capacity to work for both genders in the second year after major trauma. Surprisingly, only women demonstrated significant improvements in measures of health-related QoL and functional outcome—a finding that has to be further evaluated in greater detail in larger systematic evaluations.