ArticleJournal of the American College of Surgeons2012
Racial disparities and sex-based outcomes differences after severe injury.
Article in Journal of the American College of Surgeons, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 27 citations in OpenAlex.
- Hallmarks of the multidimensional immune response to trauma in humans.Nature immunology · 2026Review
- The "male-female health-survival paradox" in frail patients undergoing hip replacement.BMC surgery · 2026Article
- Sex dimorphisms in coagulation: Implications in trauma-induced coagulopathy and trauma resuscitation.American journal of hematology · 2024Review
- Hepatic Estrogen Sulfotransferase Distantly Sensitizes Mice to Hemorrhagic Shock-Induced Acute Lung Injury.Endocrinology · 2020Article
- Elevations in Circulating sST2 Levels Are Associated With In-Hospital Mortality and Adverse Clinical Outcomes After Blunt Trauma.The Journal of surgical research · 2019Article
- Computational evidence for an early, amplified systemic inflammation program in polytrauma patients with severe extremity injuries.PloS one · 2019Article
- Sex-based differences in outcomes after severe injury: an analysis of blunt trauma patients in China.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Article
- Inherent X-Linked Genetic Variability and Cellular Mosaicism Unique to Females Contribute to Sex-Related Differences in the Innate Immune Response.Frontiers in immunology · 2017Article
- Sex-based differences in the genomic response, innate immunity, organ dysfunction, and clinical outcomes after severe blunt traumatic injury and hemorrhagic shock.The journal of trauma and acute care surgery · 2016Article
- Race and rehabilitation following spinal cord injury: equality of access for American Indians/Alaska Natives compared to other racial groups.Injury epidemiology · 2015Article
- Gender-specific issues in traumatic injury and resuscitation: consensus-based recommendations for future research.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2014Article
- X chromosome-linked IRAK-1 polymorphism is a strong predictor of multiple organ failure and mortality postinjury.Annals of surgery · 2014Observational
- In gender-based outcomes, sex hormones may be important but it is in the genes*.Critical care medicine · 2014Article
- Cellular mosaicism for X-linked polymorphisms and IRAK1 expression presents a distinct phenotype and improves survival following sepsis.Journal of leukocyte biology · 2014Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundControversy exists about the mechanisms responsible for sex-based outcomes differences post-injury. X-chromosome-linked immune response pathway polymorphisms represent a potential mechanism resulting in sex-based outcomes differences post-injury. The prevalence of these variants is known to differ across race. We sought to characterize racial differences and the strength of any sex-based dimorphism post-injury. STUDY
designA retrospective analysis was performed using data derived from the National Trauma Data Bank 7.1 (2002-2006). Blunt-injured adult (older than 15 years) patients, surviving >24 hours and with an Injury Severity Score >16 were analyzed (n = 244,371). Patients were stratified by race (Caucasian, black, Hispanic, Asian) and multivariable regression analysis was used to characterize the risk of mortality and the strength of protection associated with sex (female vs male).
resultsWhen stratified by race, multivariable models demonstrated Caucasian females had an 8.5% lower adjusted risk of mortality (odds ratio [OR] = 0.91; 95% CI, 0.88-0.95; p < 0.001) relative to Caucasian males, with no significant association found for Hispanics or blacks. An exaggerated survival benefit was afforded to Asian females relative to Asian males, having a >40% lower adjusted risk of mortality (OR = 0.59; 95% CI, 0.44-78; p < 0.001). Asian males had a >75% higher adjusted risk of mortality relative to non-Asian males (OR = 1.77; 95% CI, 1.5-2.0; p < 0.001), and no significant difference in the mortality risk was found for Asian females relative to non-Asian females.
conclusionsThese results suggest that Asian race is associated with sex-based outcomes differences that are exaggerated, resulting from worse outcomes for Asian males. These racial disparities suggest a negative male X-chromosome-linked effect as the mechanism responsible for these sex-based outcomes differences.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.