ArticleThe journal of trauma and acute care surgery2016
Sex-based differences in the genomic response, innate immunity, organ dysfunction, and clinical outcomes after severe blunt traumatic injury and hemorrhagic shock.
Article in The journal of trauma and acute care surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 31 citations in OpenAlex.
- Hallmarks of the multidimensional immune response to trauma in humans.Nature immunology · 2026Review
- Sex dimorphisms in coagulation: Implications in trauma-induced coagulopathy and trauma resuscitation.American journal of hematology · 2024Review
- Sex Differences in Inflammation and Muscle Wasting in Aging and Disease.International journal of molecular sciences · 2023Review
- Article
- Hypercoagulability in pregnant trauma patients.Trauma surgery & acute care open · 2021Article
- Role of gender in the survival outcome of acute phase of major trauma: A nationwide, population-based study.Journal of the Chinese Medical Association : JCMA · 2020Article
- Transcriptomic Profiles of Confirmed Pediatric Tuberculosis Patients and Household Contacts Identifies Active Tuberculosis, Infection, and Treatment Response Among Indian Children.The Journal of infectious diseases · 2020Article
- A gendered magnifying glass on COVID-19.Clinical and molecular allergy : CMA · 2020Review
- Age and Sex Influence the Hippocampal Response and Recovery Following Sepsis.Molecular neurobiology · 2019Article
- Sex-based differences in transfusion need after severe injury: Findings of the PROPPR study.Surgery · 2019Article
- Temporal progression of gene regulation of peripheral white blood cells explains gender dimorphism of critically ill patients after trauma.Molecular medicine (Cambridge, Mass.) · 2019Article
- Trauma Resuscitation Consideration: Sex Matters.Journal of the American College of Surgeons · 2019Article
- Metformin ameliorates gender-and age-dependent hemodynamic instability and myocardial injury in murine hemorrhagic shock.Biochimica et biophysica acta. Molecular basis of disease · 2017Article
- Murine Models of Sepsis and Trauma: Can We Bridge the Gap?ILAR journal · 2017Review
- The influence of sex steroid hormones on the response to trauma and burn injury.Burns & trauma · 2017Review
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
introductionThe effect of sex on posttraumatic pathophysiology and outcomes after severe traumatic injury remains debated. We sought to determine the relationship of sex to the genomic and inflammatory responses, and clinical outcomes after hemorrhagic shock.
methodsWe analyzed blunt trauma patients in hemorrhagic shock from a prospective multi-institutional cohort study to assess for sex-based differences in the genomic response and clinical outcomes. Serially drawn blood samples were analyzed to evaluate peripheral leukocyte genomewide expression and circulating inflammatory mediators at intervals between 0.5 and 28 days after injury. Multivariate logistic regression models were developed to assess the effect of sex on outcomes after controlling for age, injury and shock severity, blood transfusion, and comorbidities.
resultsThe cohort consisted of 1,285 (67%) male and 643 (33%) female blunt trauma patients. Injury and shock severity were similar between the two groups. There were small but statistically significant differences between males and females regarding their age, body mass index, and 12-hour blood and crystalloid administration. Organ failure was more severe in males, with slower recovery (9.0 vs. 6.5 days) in males compared to females (p < 0.01). However, there were no differences between males and females in plasma levels of IL-6, IL-8, IL-10, IL-1β, tumor necrosis factor alpha, and monocyte chemoattractant protein 1. Multivariate analysis revealed that sex was not a significant independent risk factor for complicated recovery or 28-day mortality. Transcriptomic analysis revealed 333 genes with significant differential expression patterns between males and females (FDR, <0.001), including genes associated with general inflammation, innate immunity, cell adhesion, and cell signaling. None of the former genes were directly associated with sex hormones or X/Y chromosomes.
conclusionThere are sex-specific differences in the leukocyte genomic response to severe injury that are associated with more robust and longer-duration organ dysfunction. However, these expression patterns do not seem to be associated with sex-linked genes or circulating cytokine level differences, and do not translate to worsened sex-specific organ failure outcomes or inpatient mortality. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level III.
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