Automobile versus pedestrian injuries: Does gender matter?

Background: Automobile vs. pedestrian (AVP) injuries cause substantial morbidity and mortality. Gender may be an important factor in determining the anatomic distribution and severity of these injuries. The objective of this study was to examine the effect of gender on the nature and severity of automobile vs. pedestrian injuries and the outcome. Methods: Trauma registry study that included all AVP pedestrian injuries admitted during a 14-year period to a Level I trauma center. The following variables were included in an Excel (Microsoft Corporation, Redmond, WA) file for the purpose of this study: age, gender, body area Abbreviated Injury Score, Injury Severity Score, specific fractures (pelvic, spine, femur, tibia), survival, and intensive care unit (ICU) and hospital length of stay. Results: The study population included 6965 patients, 67.3% of whom were male. Overall, 20.7% were in the age group < 15 years, 60.5% in the age group 15-55 years, 7.6% in the age group 56-65 years, and 11.1% in the age group > 65 years. Pelvic fractures were significantly more common in females than males (20.7% vs. 11.4%, respectively, p < 0.0001). This difference was present in all age groups, but especially in the groups 56-65 years (28.5% vs. 12.3%, respectively, p < 0.0001) and > 65 years (32.5% vs. 15.7%, respectively, p < 0.0001). Males in the age group 15-55 years were significantly more likely to suffer tibia fractures (31.8% vs. 25.7%, respectively, p < 0.001). Multivariate analysis showed no difference in survival or ICU stay between the two genders, but there was a significantly longer hospital stay in males 15-65 years. Conclusions: Gender plays a significant role in the incidence of pelvic and tibial fractures but has no effect on survival or ICU stay, but male patients in the age group 15-65 years had a significantly longer hospital stay.