Injured female patients are less likely to be triaged to trauma centers when compared with similarly injured male patients.1 In this compelling study, Ingram and colleagues2 have sought to determine if delays in trauma care based on patient sex exist and if these delays correlate with differences in discharge disposition. In their retrospective review, Trauma Quality Improvement Project data using matched cohorts for male and female patients were analyzed for sex differences in 9 key efficiency measures including emergency department length of stay (ED LOS) and time to stabilizing interventions. Interestingly, the authors found that although female trauma patients have a significantly longer ED LOS than male patients, time to definitive intervention, including angiography, intracranial pressure monitor placement, and spine, femur, and pelvic fixation, was not significantly different. This finding suggests that the delay in care occurs at injury identification. This is in line with previous literature that has found longer ED LOS for female patients experiencing myocardial infarctions, drug overdoses, and strokes.3,4 This begs the question, why are the women waiting? It is known that women experience delays in radiographic imaging when compared with men and that these delays can significantly affect ED LOS. In addition, studies have shown that in health care settings, men are often regarded as stoic with high pain tolerance while women can be seen as sensitive and emotional, often having to work to have symptoms taken seriously.5 Although the reason for the sex disparity in ED LOS is unclear and likely multifactorial, implicit bias cannot be fully ruled out; thus, a closer look at our trauma triage protocols and practices is warranted.
Warner RL, Crandall M. Sex Disparities in Trauma Care—Why Are the Women Waiting? JAMA Surg. 2022;157(7):617. doi:10.1001/jamasurg.2022.1551
Artificial Intelligence Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.