ArticleJournal of the American College of Surgeons2019
Trauma Resuscitation Consideration: Sex Matters.
Article in Journal of the American College of Surgeons, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 61 citations in OpenAlex.
- Prognostic impact of body temperature trajectories from emergency department arrival to intensive care unit admission - insights from the TraumaRegister DGUScandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Estrogen as a therapeutic agent: Targeting endotheliopathy and coagulopathy in trauma.Transfusion · 2026Review
- Sex and gender bias in major trauma care: a scoping review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- High Mortality and Medical Costs in Geriatric Trauma Patients: Surgical Treatment and Risk Factors from a Retrospective Cohort Study at a Level I Trauma Center.Annals of geriatric medicine and research · 2025Article
- Obesity influences the biological response to injury: a multi-omics analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Empirical and modified hemostatic resuscitation for liver blast injury combined with seawater immersion: A preliminary study.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2025Article
- Sex dimorphisms in coagulation: Implications in trauma-induced coagulopathy and trauma resuscitation.American journal of hematology · 2024Review
- Sex differences in radiation research.International journal of radiation biology · 2024Article
- Retrospective Analysis of Bone Substitute Material for Traumatic Long Bone Fractures: Sex-Specific Outcomes.International journal of molecular sciences · 2023Article
- Age and sex differences in blood product transfusions and mortality in trauma patients at a level I trauma center.Heliyon · 2023Article
- A pilot study of the metabolic profiles of apheresis platelets modified by donor age and sex and in vitro short-term incubation with sex hormones.Transfusion · 2022Article
- Thromboelastography-Based Evaluation of Gender-Associated Hypercoagulability.The American surgeon · 2022Article
- Early coagulopathy after pediatric out-of-hospital cardiac arrest: secondary analysis of a randomized clinical trial.Thrombosis journal · 2022Article
- Full-length plasma skeletal muscle myosin isoform deficiency is associated with coagulopathy in acutely injured patients.Journal of thrombosis and haemostasis : JTH · 2022Article
- What happens after they survive? The role of anticoagulants and antiplatelets in IVC injuries.Trauma surgery & acute care open · 2022Article
- Association of antithrombin with development of trauma-induced disseminated intravascular coagulation and outcomes.Frontiers in immunology · 2022Article
- Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients.Scientific reports · 2021Article
- Trauma-induced coagulopathy.Nature reviews. Disease primers · 2021Review
- Chinese expert consensus on diagnosis and treatment of trauma-induced hypercoagulopathy.Military Medical Research · 2021Article
- Impact of Sex Differences on Mortality in Patients With Sepsis After Trauma: A Nationwide Cohort Study.Frontiers in immunology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSex dimorphisms in coagulation have been recognized, but whole blood assessment of these dimorphisms and their relationship to outcomes in trauma have not been investigated. This study characterizes the viscoelastic hemostatic profile of severely injured patients by sex, and examines how sex-specific coagulation differences affect clinical outcomes, specifically, massive transfusion (MT) and death. We hypothesized that severely injured females are more hypercoagulable and therefore, have lower rates of MT and mortality. STUDY
designHemostatic profiles and clinical outcomes from all trauma activation patients from 2 level I trauma centers were examined, with sex as an experimental variable. As part of a prospective study, whole blood was collected and thrombelastography (TEG) was performed. Coagulation profiles were compared between sexes, and association with MT and mortality were examined. Poisson regression with robust standard errors was performed.
resultsOverall, 464 patients (23% female) were included. By TEG, females had a more hypercoagulable profile, with a higher angle (clot propagation) and maximum amplitude (MA, clot strength). Females were less likely to present with hyperfibrinolysis or prolonged activating clotting time than males. In the setting of depressed clot strength (abnormal MA), female sex conferred a survival benefit, and hyperfibrinolysis was associated with higher case-fatality rate in males.
conclusionsSeverely injured females have a more hypercoagulable profile than males. This hypercoagulable status conferred a protective effect against mortality in the setting of diminished clot strength. The mechanism behind these dimorphisms needs to be elucidated and may have treatment implications for sex-specific trauma resuscitation.
Indexed as
Identifiers
What OpenQuestion holds
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.