ArticleSurgery2019
Sex-based differences in transfusion need after severe injury: Findings of the PROPPR study.
Article in Surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 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.
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
8 citing papers in PubMed.
- Estrogen as a therapeutic agent: Targeting endotheliopathy and coagulopathy in trauma.Transfusion · 2026Review
- Sex-Specific Factors Affecting Quality of Life After Major Trauma: Results of a Prospective Multicenter Registry-Based Cohort Study.Healthcare (Basel, Switzerland) · 2025Article
- Patient sex and outcomes in children with life-threatening hemorrhage.Transfusion · 2024Observational
- Sex dimorphisms in coagulation: Implications in trauma-induced coagulopathy and trauma resuscitation.American journal of hematology · 2024Review
- Sex Dimorphism in Outcome of Trauma Patients Presenting with Severe Shock: A Multicenter Cohort Study.Journal of clinical medicine · 2023Article
- Thromboelastography-Based Evaluation of Gender-Associated Hypercoagulability.The American surgeon · 2022Article
- Incidence of appendicitis during SARS-CoV-2 pandemic quarantine.Pediatrics international : official journal of the Japan Pediatric Society · 2021Article
- Quarantine and Appendicitis: A Macro-Area Experience.Pediatric gastroenterology, hepatology & nutrition · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundWomen are underrepresented in trauma research, and aggregated results of clinical trials may mask effects that differ by sex. It is unclear whether women respond differently to severe hemorrhage compared with men. We sought to evaluate sex-based differences in outcomes after severe trauma with hemorrhage.
methodsWe performed a secondary analysis of the Pragmatic Randomized Optimal Platelet and Plasma Ratios trial. Trauma patients predicted to require massive transfusion were randomized to a 1:1:1 vs 1:1:2 plasma to platelet to red blood cell transfusion ratio. Analysis was performed according to sex, controlling for clinical characteristics and transfusion arm.
resultsA total of 134 women and 546 men were analyzed. In multivariable analysis, there was no difference in mortality at 24 hours (hazard ratio for women 0.64, 95% confidence interval 0.34-1.23, P = .18) or in time to hemostasis (hazard ratio 1.10, 95% confidence interval 0.84-1.42, P = .49) by sex. We observed no difference between sexes in volume of blood products transfused during active hemorrhage. However, after anatomic hemostasis, women received lower volumes of all products, with a 38% reduction in fresh frozen plasma (mean ratio 0.62 (95% confidence interval 0.43-0.89, P = .01), 49% reduction in platelets (mean ratio 0.51, 95% confidence interval 0.33-0.79, P < .01) and 49% reduction in volume of red blood cells (mean ratio 0.51, 95% confidence interval 0.33-0.79, P < .01).
conclusionMortality and time to hemostasis of trauma patients with hemorrhage did not differ by sex. Although there was no difference in transfusion requirement during active hemorrhage, once hemostasis was achieved, women received fewer units of all blood products than men. Further research is required to determine whether women exhibit differences in coagulation during and after severe traumatic hemorrhage.
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