Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis
Abstract
:1. Background
2. Methods
2.1. Ethical Considerations
2.2. Study Population
2.3. Statistical Analysis
3. Results
3.1. Characteristics of Patients
3.2. Outcome of Propensity-Score Matched Patients
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
AIS | abbreviated injury scale |
BMI | body mass index |
CAD | coronary artery disease |
CHF | congestive heart failure |
CIs | confidence intervals |
CVA | cerebrovascular accident |
DM | diabetes mellitus |
ED | emergency department |
GCS | Glasgow coma scale |
HTN | hypertension |
ICU | intensive-care unit |
IQR | interquartile range |
ISS | injury-severity score |
LOS | length of stay |
ORs | odds ratios |
OSTA | Osteoporosis Self-Assessment Tool for Asians |
Appendix A
Variables | Female, n = 573 | Male, n = 573 | Odds Ratio (95% CI) | p |
---|---|---|---|---|
Head trauma, n (%) | ||||
Cranial fracture | 15 (2.6) | 23 (4.0) | 0.6 (0.33–1.25) | 0.187 |
Epidural hematoma (EDH) | 19 (3.3) | 17 (3.0) | 1.1 (0.58–2.18) | 0.735 |
Subdural hematoma (SDH) | 87 (15.2) | 101 (17.6) | 0.8 (0.61–1.15) | 0.264 |
Subarachnoid hemorrhage (SAH) | 49 (8.6) | 56 (9.8) | 0.9 (0.58–1.29) | 0.474 |
Intracerebral hematoma (ICH) | 20 (3.5) | 24 (4.2) | 0.8 (0.45–1.52) | 0.539 |
Cerebral contusion | 35 (6.1) | 54 (9.4) | 0.6 (0.40–0.97) | 0.036 |
Cervical vertebral fracture | 3 (0.5) | 8 (1.4) | 0.4 (0.10–1.41) | 0.130 |
Maxillofacial trauma, n (%) | ||||
Orbital fracture | 1 (0.2) | 2 (0.3) | 0.5 (0.05–5.52) | 1.000 |
Nasal fracture | 2 (0.3) | 1 (0.2) | 2.0 (0.18–22.16) | 1.000 |
Maxillary fracture | 12 (2.1) | 15 (2.6) | 0.8 (0.37–1.72) | 0.559 |
Mandibular fracture | 2 (0.3) | 0 (0.0) | - | 0.500 |
Thoracic trauma, n (%) | ||||
Rib fracture | 33 (5.8) | 45 (7.9) | 0.7 (0.45–1.14) | 0.159 |
Hemothorax | 5 (0.9) | 9 (1.6) | 0.6 (0.18–1.66) | 0.282 |
Pneumothorax | 3 (0.5) | 11 (1.9) | 0.3 (0.08–0.97) | 0.031 |
Hemopneumothorax | 2 (0.3) | 6 (1.0) | 0.3 (0.07–1.65) | 0.287 |
Thoracic vertebral fracture | 9 (1.6) | 7 (1.2) | 1.3 (0.48–3.49) | 0.615 |
Abdominal trauma, n (%) | ||||
Hepatic injury | 2 (0.3) | 3 (0.5) | 0.7 (0.11–4.00) | 1.000 |
Splenic injury | 4 (0.7) | 0 (0.0) | - | 0.124 |
Retroperitoneal injury | 1 (0.2) | 3 (0.5) | 0.3 (0.03–3.20) | 0.624 |
Renal injury | 1 (0.2) | 2 (0.3) | 0.5 (0.05–5.52) | 1.000 |
Lumbar vertebral fracture | 14 (2.4) | 8 (1.4) | 1.8 (0.74–4.25) | 0.196 |
Extremity trauma, n (%) | ||||
Scapular fracture | 2 (0.3) | 6 (1.0) | 0.3 (0.07–1.65) | 0.287 |
Clavicle fracture | 16 (2.8) | 18 (3.1) | 0.9 (0.45–1.76) | 0.728 |
Humeral fracture | 23 (4.0) | 15 (2.6) | 1.6 (0.80–3.01) | 0.187 |
Radial fracture | 52 (9.1) | 19 (3.3) | 2.9 (1.70–4.99) | <0.001 |
Ulnar fracture | 31 (5.4) | 8 (1.4) | 4.0 (1.84–8.87) | <0.001 |
Metacarpal fracture | 7 (1.2) | 7 (1.2) | 1.0 (0.35–2.87) | 1.000 |
Pelvic fracture | 9 (1.6) | 6 (1.0) | 1.5 (0.53–4.26) | 0.436 |
Femoral fracture | 291 (50.8) | 251 (43.8) | 1.3 (1.05–1.67) | 0.018 |
Patella fracture | 6 (1.0) | 9 (1.6) | 0.7 (0.23–1.88) | 0.436 |
Tibia fracture | 18 (3.1) | 14 (2.4) | 1.3 (0.64–2.63) | 0.473 |
Fibular fracture | 12 (2.1) | 9 (1.6) | 1.3 (0.56–3.21) | 0.509 |
Calcaneal fracture | 6 (1.0) | 5 (0.9) | 1.2 (0.37–3.96) | 0.762 |
Male | Motorcycle, n = 132 | Bicycle, n = 53 | Fall, n = 434 | Motorcycle vs. Fall (p) | Bicycle vs. Fall (p) |
---|---|---|---|---|---|
Age [range] (years) | 80.6 ± 5.7 [68–94] | 82.4 ± 5.6 [68–98] | 82.7 ± 6.5 [59–99] | 0.001 | 0.770 |
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Variables | Female, n = 1585 | Male, n = 663 | Odds Ratio (95% CI) | p |
---|---|---|---|---|
Age [range] (years) | 80.6 ± 6.9 [58–102] | 82.1 ± 6.3 [59–99] | - | <0.001 |
Body weight (kg) | 48.6 ± 7.1 | 52.7 ± 6.7 | - | <0.001 |
Body height (cm) | 151.7 ± 5.7 | 162.9 ± 6.1 | - | <0.001 |
Co-morbidity, n (%) | ||||
DM | 400 (25.2) | 92 (13.9) | 2.1 (1.64–2.68) | <0.001 |
HTN | 962 (60.7) | 310 (46.8) | 1.8 (1.47–2.11) | <0.001 |
CAD | 156 (9.8) | 59 (8.9) | 1.1 (0.82–1.53) | 0.488 |
CHF | 44 (2.8) | 17 (2.6) | 1.1 (0.62–1.91) | 0.778 |
CVA | 151 (9.5) | 91 (13.7) | 0.7 (0.50-0.87) | 0.003 |
Mechanism, n (%) | ||||
Motor vehicle | 9 (0.6) | 3 (0.5) | 1.3 (0.34–4.66) | 1.000 |
Motorcycle | 133 (8.4) | 132 (19.9) | 0.4 (0.28–0.48) | <0.001 |
Bicycle | 74 (4.7) | 53 (8.0) | 0.6 (0.39–0.81) | 0.002 |
Pedestrian | 56 (3.5) | 18 (2.7) | 1.3 (0.77–2.25) | 0.321 |
Fall | 1277 (80.6) | 434 (65.5) | 2.2 (1.79–2.68) | <0.001 |
Penetrating injury | 7 (0.4) | 6 (0.9) | 0.5 (0.16–1.45) | 0.222 |
Struck by/against | 29 (1.8) | 17 (2.6) | 0.7 (0.39–1.30) | 0.262 |
BAC ≥ 50 mg/dL, n (%) | 1 (0.1) | 5 (0.8) | 0.1 (0.01–0.71) | 0.010 |
GCS | 14.4 ± 1.9 | 14.1 ± 2.2 | - | 0.006 |
≤8 | 49 (3.1) | 32 (4.8) | 0.6 (0.40–0.99) | 0.044 |
9–12 | 63 (4.0) | 40 (6.0) | 0.6 (0.43–0.97) | 0.033 |
≥13 | 1473 (92.9) | 591 (89.1) | 1.6 (1.17–2.19) | 0.003 |
AIS ≥ 3, n (%) | ||||
Head/Neck | 270 (17.0) | 188 (28.4) | 0.5 (0.42–0.64) | <0.001 |
Face | 0 (0.0) | 0 (0.0) | - | - |
Thorax | 34 (2.1) | 40 (6.0) | 0.3 (0.21–0.54) | <0.001 |
Abdomen | 15 (0.9) | 5 (0.8) | 1.3 (0.46–3.47) | 0.658 |
Extremity | 991 (62.5) | 327 (49.3) | 1.7 (1.43–2.06) | <0.001 |
ISS, median (IQR) | 9 (9–9) | 9 (9–13) | - | 0.001 |
<16 | 1369 (86.4) | 512 (77.2) | 1.9 (1.48–2.36) | <0.001 |
16–24 | 161 (10.2) | 118 (17.8) | 0.5 (0.40–0.68) | <0.001 |
≥25 | 55 (3.5) | 33 (5.0) | 0.7 (0.44–1.07) | 0.093 |
Mortality, n (%) | 44 (2.8) | 40 (6.0) | 0.4 (0.29–0.69) | <0.001 |
LOS in hospital (days) | 9.6 ± 8.3 | 11.2 ± 11.4 | - | 0.001 |
ICU admission, n (%) | 308 (19.4) | 197 (29.7) | 0.6 (0.46–0.70) | <0.001 |
LOS in ICU (days) | 7.1 ± 9.7 | 8.6 ± 10.0 | - | 0.097 |
Variables | Before Matching | After Matching | ||||||
---|---|---|---|---|---|---|---|---|
Female, n = 1585 | Male, n = 663 | Odds Ratio (95% CI) | p | Female, n = 573 | Male, n = 573 | Odds Ratio (95% CI) | p | |
Age (years) | 80.6 ± 6.9 | 82.1 ± 6.3 | - | <0.001 | 81.4 ± 6.3 | 81.8 ± 6.4 | - | 0.402 |
Co-morbidity, n (%) | ||||||||
DM | 400 (25.2) | 92 (13.9) | 2.1 (1.64–2.68) | <0.001 | 80 (1.4) | 80 (1.4) | 1.0 (0.72–1.40) | 1.000 |
HTN | 962 (60.7) | 310 (46.8) | 1.8 (1.47–2.11) | <0.001 | 282 (49.2) | 282 (49.2) | 1.0 (0.79–1.26) | 1.000 |
CAD | 156 (9.8) | 59 (8.9) | 1.1 (0.82–1.53) | 0.488 | 49 (8.6) | 49 (8.6) | 1.0 (0.66–1.51) | 1.000 |
CHF | 44 (2.8) | 17 (2.6) | 1.1 (0.62–1.91) | 0.778 | 12 (2.1) | 12 (2.1) | 1.0 (0.45–2.25) | 1.000 |
CVA | 151 (9.5) | 91 (13.7) | 0.7 (0.50–0.87) | 0.003 | 73 (12.7) | 73 (12.7) | 1.0 (0.71–1.42) | 1.000 |
Mechanism, n (%) | ||||||||
Motor vehicle | 9 (0.6) | 3 (0.5) | 1.3 (0.34–4.66) | 1.000 | 1 (0.2) | 1 (0.2) | 1.0 (0.06–16.03) | 1.000 |
Motorcycle | 133 (8.4) | 132 (19.9) | 0.4 (0.28–0.48) | <0.001 | 80 (14.0) | 80 (14.0) | 1.0 (0.72–1.40) | 1.000 |
Bicycle | 74 (4.7) | 53 (8.0) | 0.6 (0.39–0.81) | 0.002 | 39 (6.8) | 39 (6.8) | 1.0 (0.63–1.58) | 1.000 |
Pedestrian | 56 (3.5) | 18 (2.7) | 1.3 (0.77–2.25) | 0.321 | 15 (2.6) | 15 (2.6) | 1.0 (0.48–2.07) | 1.000 |
Fall | 1277 (80.6) | 434 (65.5) | 2.2 (1.79–2.68) | <0.001 | 427 (74.5) | 427 (74.5) | 1.0 (0.77–1.30) | 1.000 |
Penetrating injury | 7 (0.4) | 6 (0.9) | 0.5 (0.16–1.45) | 0.222 | 1 (0.2) | 1 (0.2) | 1.0 (0.06–16.03) | 1.000 |
Struck by/against | 29 (1.8) | 17 (2.6) | 0.7 (0.39–1.30) | 0.262 | 10 (1.7) | 10 (1.7) | 1.0 (0.41–2.42) | 1.000 |
ISS, median (IQR) | 9 (9–9) | 9 (9–13) | - | 0.001 | 9 (9–13) | 9 (9–13) | - | 0.400 |
Variables | Propensity-Score Matched Cohort | |||
---|---|---|---|---|
Female, n = 573 | Male, n = 573 | Odds Ratio (95% CI) | p | |
Mortality, n (%) | 19 (3.3) | 36 (6.3) | 0.5 (0.29–0.90) | 0.019 |
LOS in hospital (days) | 10.4 ± 9.3 | 11.3 ± 11.5 | - | 0.154 |
ICU admission, n (%) | 143 (25.0) | 172 (30.0) | 0.8 (0.60–1.01) | 0.055 |
LOS in ICU (days) | 7.6 ± 10.0 | 8.8 ± 10.4 | - | 0.286 |
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Tang, C.-E.; Liu, H.-T.; Kuo, P.-J.; Chen, Y.-C.; Hsu, S.-Y.; Lin, C.-C.; Hsieh, C.-H. Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis. Int. J. Environ. Res. Public Health 2018, 15, 418. https://doi.org/10.3390/ijerph15030418
Tang C-E, Liu H-T, Kuo P-J, Chen Y-C, Hsu S-Y, Lin C-C, Hsieh C-H. Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis. International Journal of Environmental Research and Public Health. 2018; 15(3):418. https://doi.org/10.3390/ijerph15030418
Chicago/Turabian StyleTang, Chien-En, Hang-Tsung Liu, Pao-Jen Kuo, Yi-Chun Chen, Shiun-Yuan Hsu, Chih-Che Lin, and Ching-Hua Hsieh. 2018. "Impact of Sexual Dimorphism on Trauma Patterns and Clinical Outcomes of Patients with a High-Risk Score of the Osteoporosis Self-Assessment Tool for Asians: A Propensity Score-Matched Analysis" International Journal of Environmental Research and Public Health 15, no. 3: 418. https://doi.org/10.3390/ijerph15030418