The objective of this study was to estimate the independent association of sex with outcome after mild traumatic brain injury (mild TBI). We performed an analysis of a subset of an established cohort involving 1425 mild TBI patients presenting to an academic emergency department (ED). The associations between sex and 3 outcomes determined 3 months after the initial ED visit were examined: post-concussive symptom (PCS) score (0, 1-5, 6-16, > 16), the number of days to return of normal activities (0, 1-7, >7), and the number of days of work missed (0, 1-7, > 7). Logistic regression analyses were used to determine the relationship between sex and each outcome after controlling for 12 relevant subject-level variables. Of the 1425 subjects, 643 (45.1%) were female and 782 (54.9%) were male. Three months after mild TBI, males had a significantly lower odds of being in a higher PCS score category (odds ratio [OR] 0.62, 95% CI: 0.50, 0.78); this association appeared to be more prominent during childbearing years for females. Males and females did not significantly differ with respect to the odds of poorer outcome defined by the number of days to return of normal activities or the number of days of work missed. Female sex is associated with a significantly higher odds of poor outcome after mild TBI, as measured by PCS score, after control for appropriate confounders. The observed pattern of peak disability for females during the childbearing years suggests disruption of endogenous estrogen or progesterone production. Attempts to better understand how mild TBI affects production of these hormones acutely after injury and during the recovery period may shed light on the mechanism of poorer outcome among females and putative therapeutic interventions.
Mendeley saves you time finding and organizing research
Choose a citation style from the tabs below