Gender based differences in the genomic response, innate immunity, organ dysfunction and clinical outcomes after severe blunt traumatic injury and hemorrhagic shock

Maria Cecelia Lopez, Phillip A. Efron, Tezcan Ozrazgat-Baslanti, Jianyi Zhang, Joseph Cuschieri, Ronald V. Maier, Joseph P. Minei, Henry V. Baker, Frederick A. Moore, Lyle L. Moldawer, Scott C. Brakenridge

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

INTRODUCTION: The effect of gender on post-traumatic pathophysiology and outcomes after severe traumatic injury remains debated. We sought to determine the relationship of gender to the genomic and inflammatory responses, and clinical outcomes after hemorrhagic shock. METHODS: We analyzed blunt trauma patients in hemorrhagic shock from a prospective, multi-institutional cohort study to assess for gender based differences in the genomic response and clinical outcomes. Serially drawn blood samples were analyzed to evaluate peripheral leukocyte genome-wide 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 gender on outcomes after controlling for age, injury and shock severity, blood transfusion, and comorbidities. RESULTS: The 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, BMI, 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

Original languageEnglish (US)
JournalJournal of Trauma and Acute Care Surgery
DOIs
StateAccepted/In press - Jun 14 2016

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Traumatic Shock
Nonpenetrating Wounds
Hemorrhagic Shock
Innate Immunity
Wounds and Injuries
Shock
Logistic Models
Blood Transfusion
Comorbidity
Leukocytes
Cohort Studies
Genome

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

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Gender based differences in the genomic response, innate immunity, organ dysfunction and clinical outcomes after severe blunt traumatic injury and hemorrhagic shock. / Lopez, Maria Cecelia; Efron, Phillip A.; Ozrazgat-Baslanti, Tezcan; Zhang, Jianyi; Cuschieri, Joseph; Maier, Ronald V.; Minei, Joseph P.; Baker, Henry V.; Moore, Frederick A.; Moldawer, Lyle L.; Brakenridge, Scott C.

In: Journal of Trauma and Acute Care Surgery, 14.06.2016.

Research output: Contribution to journalArticle

Lopez, Maria Cecelia ; Efron, Phillip A. ; Ozrazgat-Baslanti, Tezcan ; Zhang, Jianyi ; Cuschieri, Joseph ; Maier, Ronald V. ; Minei, Joseph P. ; Baker, Henry V. ; Moore, Frederick A. ; Moldawer, Lyle L. ; Brakenridge, Scott C. / Gender based differences in the genomic response, innate immunity, organ dysfunction and clinical outcomes after severe blunt traumatic injury and hemorrhagic shock. In: Journal of Trauma and Acute Care Surgery. 2016.
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abstract = "INTRODUCTION: The effect of gender on post-traumatic pathophysiology and outcomes after severe traumatic injury remains debated. We sought to determine the relationship of gender to the genomic and inflammatory responses, and clinical outcomes after hemorrhagic shock. METHODS: We analyzed blunt trauma patients in hemorrhagic shock from a prospective, multi-institutional cohort study to assess for gender based differences in the genomic response and clinical outcomes. Serially drawn blood samples were analyzed to evaluate peripheral leukocyte genome-wide 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 gender on outcomes after controlling for age, injury and shock severity, blood transfusion, and comorbidities. RESULTS: The 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, BMI, 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",
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