Prospective analysis of the gender-specific role of steroid hormone levels in the outcome in severely injured patients

• Applicant: Dr. Olivia Mair
• Subject Area: Orthopaedics, Traumatology, Reconstructive Surgery
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 546925525

In recent years, awareness of gender-specific differences has steadily increased, even among trauma patients. This awareness paves the way for personalized medicine, increasingly taking into account the inherent diverse needs of men and women in the diagnosis and treatment following severe trauma. Currently, women and men are generally treated equally after severe traumas. However, gender dimorphism is widely acknowledged in the literature. For instance, it has been demonstrated that, upon surviving the initial severe trauma, women are less likely to succumb during an intensive care unit stay. This is attributed to the fact that women less frequently experience serious complications, particularly systemic inflammatory response syndrome (SIRS) and sepsis. One of the key theories explaining these survival differences and outcomes following severe trauma is the positive effect of female steroid hormones. Estradiol and its derivatives, as well as progesterone, lower the levels of proinflammatory cytokines such as IL-1, IL-6, TNF-alpha, and TGF-beta. Elevated levels of these cytokines are, among other factors, responsible for the development of sepsis and SIRS. Similarly, after traumatic brain injuries, these proinflammatory cytokines play a significant role as contributors to the development of the so-called secondary brain injury. They lead, among other effects, to increased intracranial pressure, brain edema, and the impairment of the blood-brain barrier. As current data emphasize the necessity to consider gender as a critical factor in the individual care of trauma patients, we aim to investigate the role of steroid hormones in influencing outcomes and mortality after severe trauma. These investigations will be conducted in patients with polytrauma or isolated severe traumatic brain injury, taking into account all aspects of existing hormonal influences such as oral substitution, pre-existing conditions, tumors, etc. This study will be the first to examine the steroid hormone levels at the time of trauma and their associated outcomes in a clinical setting. The goal is to generate data that will serve as the foundation for an adapted, personalized therapy for both female and male patients after severe trauma.

• DFG Programme: Research Grants