Zhi-Jie Hong1,2,3,4, Matthew Firek1, Bishoy Zachary1, Katharina Mörs5, Cora Schindler5, Ingo Marzi5, Jyh-Cherng Yu3,4, Raul Coimbra6,7. 1. Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, 26520 Cactus Ave., CPC Building, Suite 102-5, Riverside, Moreno Valley, CA, 92555, USA. 2. Division of Traumatology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. 3. Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC. 4. Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC. 5. Department of Trauma, Hand and Reconstructive Surgery, University of Frankfurt, Frankfurt, Germany. 6. Comparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical Center, 26520 Cactus Ave., CPC Building, Suite 102-5, Riverside, Moreno Valley, CA, 92555, USA. r.coimbra@ruhealth.org. 7. Department of Surgery, Loma Linda University School of Medicine, Loma Linda, CA, USA. r.coimbra@ruhealth.org.
Abstract
PURPOSE: The impact of female sex on traumatic brain injury (TBI) outcomes remains controversial. The combined impact of age and sex on TBI outcomes must be clarified. We hypothesized that females have better outcomes than males in the premenopausal age group. METHODS: Data from the 2007-2016 National Trauma Data Bank of the Committee on Trauma-American College of Surgeons were used. Of a total of 686,549 patients with moderate to severe TBI (AIS ≥ 3), 251,491 were female. Comparison analyses of clinical characteristics and outcomes between females and males were conducted at different age groups: < 45 years, 45-55, and > 55 years. Logistic regressions were performed to assess the impact of age and female sex on mortality and complications. RESULTS: Mortality rate between females and males aged < 45 and 45-55 years was similar, but significantly reduced in the > 55 years group. After multivariate logistic regression analysis controlling for multiple confounding factors, we found that females aged > 55 years had markedly decreased risk of mortality (AOR: 0.857, 95% CI 0.835-0.879, p < 0.001) and complications. CONCLUSION: Female patients in the postmenopausal stage have better outcomes following TBI than males, but pre- and perimenopausal females do not, suggesting that female sexual hormones may not provide a significant protective effect on clinical outcomes following isolated moderate to severe TBI.
PURPOSE: The impact of female sex on traumatic brain injury (TBI) outcomes remains controversial. The combined impact of age and sex on TBI outcomes must be clarified. We hypothesized that females have better outcomes than males in the premenopausal age group. METHODS: Data from the 2007-2016 National Trauma Data Bank of the Committee on Trauma-American College of Surgeons were used. Of a total of 686,549 patients with moderate to severe TBI (AIS ≥ 3), 251,491 were female. Comparison analyses of clinical characteristics and outcomes between females and males were conducted at different age groups: < 45 years, 45-55, and > 55 years. Logistic regressions were performed to assess the impact of age and female sex on mortality and complications. RESULTS: Mortality rate between females and males aged < 45 and 45-55 years was similar, but significantly reduced in the > 55 years group. After multivariate logistic regression analysis controlling for multiple confounding factors, we found that females aged > 55 years had markedly decreased risk of mortality (AOR: 0.857, 95% CI 0.835-0.879, p < 0.001) and complications. CONCLUSION: Female patients in the postmenopausal stage have better outcomes following TBI than males, but pre- and perimenopausal females do not, suggesting that female sexual hormones may not provide a significant protective effect on clinical outcomes following isolated moderate to severe TBI.
Authors: Johannes Leitgeb; Walter Mauritz; Alexandra Brazinova; Ivan Janciak; Marek Majdan; Ingrid Wilbacher; Martin Rusnak Journal: J Trauma Date: 2011-12
Authors: Andrew R Mayer; Andrew B Dodd; Julie G Rannou-Latella; David D Stephenson; Rebecca J Dodd; Josef M Ling; Carissa J Mehos; Cidney R Robertson-Benta; Sharvani Pabbathi Reddy; Rachel E Kinsler; Meghan S Vermillion; Andrew P Gigliotti; Veronik Sicard; Amy L Lloyd; Erik B Erhardt; Jessica M Gill; Chen Lai; Vivian A Guedes; Irshad H Chaudry Journal: Crit Care Date: 2021-12-16 Impact factor: 9.097