Sex Hormones and Gender Effects following Trauma-Hemorrhage

Trauma is the leading cause of death in the industrialized world between the ages of one and 40. A number of risk factors including age and gender have been implicated in this regard. It is therefore not surprising that the majority of trauma vic-tims are young males. Their mortality rate following trauma is not only higher compared to females, but they are also more prone to subsequent sepsis. Age and gender are therefore important factors in the prevalence of traumatic injury as well as in susceptibility to subsequent septic complications.

trauma, mortality, age, gender, sex hormones, sepsis, car-diovascular/immunological altera-tions

1. Choudhry MA, Schwacha MG, Hubbard WJ, Kerby JD, Rue LW, Bland KI, et al. Gender differences in acute response to trauma-hemorr-hage. Shock 2005;24 (Suppl 1):101-6.

2. Bone RC. Toward an epidemiology and natural history of SIRS (systemic inflammatory response syndrome). JAMA 1992;268:3452-5.

3. Angele MK, Schwacha MG, Ayala A, Chaudry IH. Effect of gender and sex hormones on immune responses following shock. Shock 2000;14:81-90.

4. Raju R, Chaudry IH. Sex steroids/receptor antagonist: Their use as adjuncts following trauma-hemorrhage for improving immune/cardio-vascular responses and decreasing mortality from subsequent sepsis. Anesth & Analg 2008;107:159-66.

5. Yu H-P, Chaudry IH. The role of estrogen and receptor agonists in maintaining organ function following trauma-hemorrhage. Shock 2009;31:227-37.

6. George RL, McGwin G Jr, Windham ST, Melton SM, Metzger J, Chaudry IH, et al. Age-related gender differential in outcome following blunt or penetrating trauma. Shock 2003;19:28-32.

7. Frink M, Pape H-C, Griensven MV, Krettek C, Chaudry IH, Hildebrand F. Influence of sex and age on MODS and cytokines after multiple injuries. Shock 2007;27:151-6.

8. Deitch EA, Livingston DH, Lavery RF, Monaghan SF, Bongu A, Machiedo GW. Hormonally active women tolerate shock-trauma better than do men: a prospective study of over 4000 trauma patients. Ann Surg 2007;246:447-453.

9. Adrie C, Azoulay E, Francais A, Clec'h C, Darques L, Schwebel C, et al. Influence of gender on the outcome of severe sepsis – A reappraisal. Chest 2007;132:1786-93.

10. Chen JG, Not L, Ng T, Hubbard WJ, Chatham J, Choudhry MA, et al. 17􀀁-estradiol (E2) administration after major blood loss improves liver ATP, 3-hour survival and also long-term survival following prolonged hypotension (3 hour) and fluid resuscitation. Shock 2006;25 (Suppl 1):11.