Trauma outcomes differences in females: a prospective analysis of 76 000 trauma patients in the Asia-Pacific region and the contributing factors

Bin Kunji Mohamad MI 1 , Jamaluddin SF 2 , Ahmad N 3 , Bahar A 4 , Khalid ZM 3 , Binti Mohd Zaki NA 3 Show all authors , Norzan NA 5 , Shin SD 6 , Shaun GE 7 , Chiang WC 8 , Kajino K 9 , Song KJ 10 , Son DN 11

Affiliations 

  • 1 Faculty of Medicine, Universiti Teknologi MARA, UITM Sungai Buloh Campus, Jalan Hospital, Sungai Buloh, Selangor, 47000, Malaysia. iqhbal9966@uitm.edu.my
  • 2 Faculty of Medicine, Universiti Teknologi MARA, UITM Sungai Buloh Campus, Jalan Hospital, Sungai Buloh, Selangor, 47000, Malaysia
  • 3 Department of Mathematical Sciences, Faculty of Science, Universiti Teknologi Malaysia, Johor Bahru, Malaysia
  • 4 UTM-Centre for Industrial and Applied Mathematics, Universiti Teknologi Malaysia, Johor Bahru, 81310, Malaysia
  • 5 Emergency and Trauma Department, Sungai Buloh Hospital, Jalan Hospital, Sungai Buloh, Selangor, 47000, Malaysia
  • 6 Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea
  • 7 Emergency Department, Woodlands Health Campus, Houston, Singapore
  • 8 Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 9 Department of Emergency and Critical Care Medicine, Kansai Medical University, Hirakata, Osaka, Japan
  • 10 Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
  • 11 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Vietnam
Scand J Trauma Resusc Emerg Med, 2025 Feb 24;33(1):34.
PMID: 39994732 DOI: 10.1186/s13049-025-01342-1

Abstract

BACKGROUND: Trauma is a leading cause of mortality, particularly in low and middle-income countries. While extensively studied in North America and Europe, data from the Asia-Pacific are limited. An important area of research is the difference in trauma outcomes, which are theoretically noted to be better among females. However, the clinical findings are inconclusive among Asians. This study examines sex-based differences in trauma outcomes in Asia Pacific, focusing on in-hospital mortality and functional recovery at discharge.

METHODS: This observational study, from the Pan-Asia Trauma Outcomes Study (PATOS), included 76,645 trauma patients from 12 Asian Pacific countries. We analysed in-hospital mortality and functionality at discharge using the Glasgow Outcome Scale (GOS) and the modified Rankin Scale (mRS). Logistic regression models were built to test the association of sex on the outcomes.

RESULTS: Males exhibited higher in-hospital mortality (1.6%) compared to females (1.06%) ( p  50 years and ISS > 15.

CONCLUSION: This study indicates no difference in the general trauma outcomes in the Asia Pacific between females and males. Although younger females with less severe injuries had better functional outcomes, this advantage disappeared in severe injuries and those over 50 years. These results align with some previous studies, and understanding the nuances may lead to more tailored trauma care, potentially improving patient outcomes.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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