Influence of gender on systemic IL-6 levels, complication rates and outcome after major trauma

BackgroundWhile female gender was associated with lower rates of systemic inflammatory response syndrome (SIRS), sepsis and single and/or multiple organ failure (MOF), contradictory data suggest no correlation between gender and complication rates and/or outcome in trauma patients (TP). Here, we analyzed the gender influence on systemic interleukin (IL)-6 levels and outcome in TP.Patients/Methods343 TP with injury severity scores (ISS) ≥16 were included upon admittance to the emergency department (ED) and grouped to male (n = 257) vs. female (n = 86). Injury severity, vital signs, physiological parameters, length of intensive care unit (ICU) and in-hospital stay, outcome parameters including SIRS, sepsis, respiratory complications, single- and/or MOF and in-hospital mortality were analyzed. Systemic IL-6 levels during the first 10 post-injury days were determined daily.ResultsAge (45.0 ± 1.0 vs. 48.2 ± 2.1) and ISS (27.1 ± 0.8 vs. 24.7 ± 1.2) were comparable between both groups. Abbreviated Injury Scale (AIS) ≥3 of chest and abdominal body regions were significantly higher in male TP (chest:51.02% vs. 36.05%, abdomen:19.84% vs. 10.47%, p < 0.05). IL-6 was significantly increased in male TP on post-injury days 1 and 2 (d1:363.9 ± 72.58 vs. 163.7 ± 25.98; d2:194.3 ± 31.38 vs. 114.3 ± 17.81 pg/ml, p < 0.05). Multivariate analysis excluded an association of increased chest or abdominal injury occurrence with IL-6 levels. Female vs. male TP had significantly lower SIRS and sepsis occurrence (SIRS:40.70% vs. 53.31%, sepsis:6.98% vs. 19.46%, p < 0.05). There were no gender-based differences regarding ICU or in-hospital stay, single and/or MOF and respiratory complications.ConclusionsTaken together, higher systemic IL-6 levels after trauma are associated with enhanced susceptibility for SIRS and sepsis in male patients.