Gender-based disparities in burn injuries, care and outcomes: A World Health Organization (WHO) Global Burn Registry cohort study

Mehta, Kajal; Arega, Hana; Smith, Natalie; Li, Kathleen; Gause, Emma; Lee, Joohee; Stewart, Barclay T

doi:10.1016/j.amjsurg.2021.07.041

Cited by 29 publications

(8 citation statements)

References 28 publications

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“…An essential commonality between these studies and our own is that patients who did not receive surgery were excluded, and it is certainly possible that this influenced results. Indeed, a study of the World Health Organization Global Burn Registry, which included patients regardless of surgical status, found that female patients had lower rates of surgical treatment and higher mortality rates than males [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Sex‐Based Differences in Survival Among Patients with Acute Abdomen Undergoing Surgery in Malawi: A Propensity Weighted Analysis

et al. 2023

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Introduction Sex disparities in access to health care in low-resource settings have been demonstrated. Still, there has been little research on the effect of sex on postoperative outcomes. We evaluated the relationship between sex and mortality after emergency abdominal surgery. Methods We performed a retrospective cohort study using the acute care surgery database at Kamuzu Central Hospital (KCH) in Malawi. We included patients who underwent emergency abdominal surgery between 2013 and 2021. We created a propensity score weighted Cox proportional hazards model to assess the relationship between sex and inpatient survival. Results We included 2052 patients in the study, and 76% were males. The most common admission diagnosis in both groups was bowel obstruction. Females had a higher admission shock index than males (0.91 vs. 0.81, p < 0.001) and a longer delay from admission until surgery (1.47 vs. 0.79 days, p < 0.001). Females and males had similar crude postoperative mortality (16.3% vs. 15.3%, p = 0.621). The final Cox proportional hazards regression model was based on the propensity-weighted cohort. The mortality hazard ratio was 0.65 among females compared to males (95% CI 0.46–0.92, p = 0.014). Conclusions Our results show a survival advantage among female patients undergoing emergency abdominal surgery despite sex-based disparities in access to surgical care that favors males. Further research is needed to understand the mechanisms underlying these findings.

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Section: Discussionmentioning

confidence: 99%

“…In some settings, female patients cannot even access health services without being accompanied by a male relative [ 9 ]. Women in low- and middle-income countries (LMICs) present to a health care facility less frequently when compared to men in similar medical circumstances [ 4 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Sex‐Based Differences in Survival Among Patients with Acute Abdomen Undergoing Surgery in Malawi: A Propensity Weighted Analysis

et al. 2023

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“…[ 7 , 8 ] It has also been observed that women in LMICs have higher mortality rates than men and that children <5 years old are more at risk. [ 9 , 10 ] The strong socio-economic gradients observed between countries also exist within countries. Delgado et al showed that environmental factors such as low income, crowding and lack of water supply are associated with an increased risk of burns.…”

Section: Introductionmentioning

confidence: 99%

Acute burn care and outcomes at the Hospital Nacional Guido Valadares (HNGV), Timor-Leste: A 7-year retrospective study

Salendo

Ximenes²,

Soares³

et al. 2022

Medicine

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The purpose of this study was to describe the epidemiology of patients presenting with acute burns and undergoing admission at Hospital Nacional Guido Valadares (HNGV) in Dili, Timor-Leste in the period 2013 to 2019. HNGV is the only tertiary referral hospital in Timor-Leste. This was a retrospective study involving all acute burn patients admitted to the surgical wards of HNGV from 2013 to 2019. The data was collected from patient charts and hospital medical archives. Data were reviewed and analyzed statistically in terms of age, gender, residence, cause, total body surface area (TBSA), burns depth, length of stay (LOS), and mortality. The outcomes were analyzed using logistic regression. Over the 7-year period, there were 288 acute burn patients admitted to the surgical wards of HNGV. Most patients were children (55%), male (65%) and from the capital city of Dili or surrounding areas (59%). The most common cause of burns in children was scalds and the most common cause among adults was flames. Of the admitted patients 59% had burns affecting >10% of the TBSA and 41% had full thickness burns. The median LOS was 17 days (1–143) and the average mortality for admitted burn patients in HNGV was 5.6% (annual mortality 0–17%). The odds ratio for extended LOS was 1.9 (95% confidence interval 1.1–3.2) in female compared with male patients. The odds ratio for mortality was 14.6 (95% confidence interval 2.7–80.6) in the older adults when compared with younger adults. Higher TBSA, full thickness burns, and flame burns were also significantly associated with longer LOS and higher mortality. Children and male patients were disproportionately overrepresented among patients admitted to HNGV, while female patients had longer LOS and older adults had more severe injury and a higher risk of mortality. Establishment of a national program for the prevention of burns is essential.

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“…Death is a universal phenomenon, but the reaction towards death is influenced by the culture, religion, and environment in which a person lives (Kopel, & Webb, 2022;Marchi, 2022). There also exists gender differences in the experience and expression of trauma related death (Mehta et al, 2022;Pineles et al, 2017). It has been long history of struggle to construct the international identity of feminism, there is a long debate that how women go through conflicts, regardless of their unique differences (Rupp, 2022).…”

Section: Introductionmentioning

confidence: 99%

Experience of Death-Related Trauma in Women: An Interpretative Phenomenological Analysis

Rani

Saleem

Subhan

2022

JPAP

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The trauma related to death is always an intense emotional and psychological experience that tend to shake the stability of life. Through Interpretative Phenomenological Analysis (IPA), this study explored the experience and expression of trauma related to the death of a close family member in women. A sample of 5 women of age ranging from 22 to 30 years were targeted and information was collected through a semi-structured interview. The superordinate themes emerged as Socio-emotional responses to trauma, and sub-ordinated themes were Stigmatization, Resistance, Emotional Difficulties, Unstable Relationships, Fear of Being Exploited, Economic Difficulties and Social Withdrawal. This study helps to understand reactions to death in the cultural context of trauma counseling and early intervention services.

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Gender-based disparities in burn injuries, care and outcomes: A World Health Organization (WHO) Global Burn Registry cohort study

Cited by 29 publications

References 28 publications

Sex‐Based Differences in Survival Among Patients with Acute Abdomen Undergoing Surgery in Malawi: A Propensity Weighted Analysis

Sex‐Based Differences in Survival Among Patients with Acute Abdomen Undergoing Surgery in Malawi: A Propensity Weighted Analysis

Acute burn care and outcomes at the Hospital Nacional Guido Valadares (HNGV), Timor-Leste: A 7-year retrospective study

Experience of Death-Related Trauma in Women: An Interpretative Phenomenological Analysis

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