Sex Differences in In-hospital Complications Among Older Adults After Traumatic Brain Injury

Adediran, Timileyin; Drumheller, Byron C.; McCunn, Maureen; Stein, Deborah M.; Albrecht, Jennifer S.

doi:10.1016/j.jss.2019.05.053

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…The association of non-neurological complication with higher mortality suggested that efforts to mitigate post-trauma complications might be an important target for intervention. Indeed, these complications impact in-hospital mortality, especially in elderly patients [ 31 ]. TBI triggers a complex cascade of molecular and cellular events associated with a systemic inflammatory reaction and secondary extracranial organ damage [ 29 – 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, these complications impact in-hospital mortality, especially in elderly patients [ 31 ]. TBI triggers a complex cascade of molecular and cellular events associated with a systemic inflammatory reaction and secondary extracranial organ damage [ 29 – 31 ]. Circulating pro-inflammatory cytokines and chemokines following TBI are potentially responsible for ARDS and acute kidney injury [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

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Sex and age differences in isolated traumatic brain injury: a retrospective observational study

et al. 2021

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Background Among the many factors that may influence traumatic brain injury (TBI) progression, sex is one of the most controversial. The objective of this study was to investigate sex differences in TBI-associated morbidity and mortality using data from the largest trauma registry in Japan. Methods This retrospective, population-based observational study included patients with isolated TBI, who were registered in a nationwide database between 2004 and 2018. We excluded patients with extracranial injury (Abbreviated Injury Scale score ≥ 3) and removed potential confounding factors, such as non-neurological causes of mortality. Patients were stratified by age and mortality and post-injury complications were compared between males and females. Results A total of 51,726 patients with isolated TBI were included (16,901 females and 34,825 males). Mortality across all ages was documented in 12.01% (2030/16901) and 12.76% (4445/34825) of males and females, respectively. The adjusted odds ratio (OR) of TBI mortality for males compared to females was 1.32 (95% confidence interval [CI], 1.22–1.42]. Males aged 10–19 years and ≥ 60 years had a significantly higher mortality than females in the same age groups (10–19 years: adjusted OR, 1.97 [95% CI, 1.08–3.61]; 60–69 years: adjusted OR, 1.24 [95% CI, 1.02–1.50]; 70–79 years: adjusted OR, 1.20 [95% CI, 1.03–1.40]; 80–89 years: adjusted OR, 1.50 [95% CI, 1.31–1.73], and 90–99 years: adjusted OR, 1.72 [95% CI, 1.28–2.32]). In terms of the incidence of post-TBI neurologic and non-neurologic complications, the crude ORs were 1.29 (95% CI, 1.19–1.39) and 1.14 (95% CI, 1.07–1.22), respectively, for males versus females. This difference was especially evident among elderly patients (neurologic complications: OR, 1.27 [95% CI, 1.14–1.41]; non-neurologic complications: OR, 1.29 [95% CI, 1.19–1.39]). Conclusions In a nationwide sample of patients with TBI in Japan, males had a higher mortality than females. This disparity was particularly evident among younger and older generations. Furthermore, elderly males experienced more TBI complications than females of the same age.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sex and age differences in isolated traumatic brain injury: a retrospective observational study

et al. 2021

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“…Patients' median ages were 39 and 80% of them were men in a study by Gupta et al (14) . Previous studies using sizable samples (> 10,000 patients in various trauma centers) gathered from national registries and showing that males had a greater mortality rate following TBI in comparison to girls of the same age (15,16) . This is in agreement with the results of our study.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Vital Signs at Presentation in Individuals with Severe Traumatic Brain Injuries

El-Azzeim¹,

El-Aziz²,

Ali³

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: Throughout the world, traumatic brain injury (TBI) is a leading cause of mortality and morbidity. It can be brought on by a variety of factors, including falls from great heights, gunfire, and traffic accidents. The number of injuries being treated in the emergency room is rising, and in severe trauma cases, the fatality rate might be as high as 50%. Objective: To improve the outcome of TBI patients by analyzing the vital signs at presentation and their role as a predictor to the outcome in patients with isolated TBI. Methods: Prospective analytical study that included 110 adult traumatic patients presented to Emergency Department in Suez Canal University Hospital with severe TBI. Results: Studying of the demographic data of both groups showed that most of cases 75 (68%) are males, while females were only 35 (32%). The average heart rate was higher (100 beat/min) in cases with bad outcome compared to (89 beat/min) in cases with good outcome. The mean respiratory rate was higher (22 breath/min) in cases with bad outcome compared to (20 breath/min) in cases with good outcome. Both mean systolic and diastolic blood pressure were lower in cases with bad outcome than in cases with good outcome. Measured oxygen saturation was much lower (mean 91.6 %) in cases with bad outcome at presentation compared to 95.9 % in cases with good outcome. Conclusion: Tachycardia, tachypnea, hypotension and lower levels of oxygen saturation were evident in cases with bad outcome in sever TBI patients.

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“…[2,[31][32][33] Similarly, in neurosurgical emergency patients, sex-related discrepancies are reported. [34,35,36] In case of elective intracranial surgery, on the contrary, data concerning these sex-related differences are scarce, with some exceptions, such as in patients with glioblastoma or meningioma. [16][17][18][19] So far, very little is known about the frequency of short-term complications following elective craniotomy.…”

Section: Discussionmentioning

confidence: 99%

Sex-related differences in postoperative complications following elective craniotomy for intracranial lesions: An observational study

et al. 2022

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Introduction: The integration of sex-related differences in neurosurgery is crucial for new, possible sex-specific, therapeutic approaches. In neurosurgical emergencies, such as traumatic brain injury and aneurysmal subarachnoid hemorrhage, these differences have been investigated. So far, little is known concerning the impact of sex on frequency of postoperative complications after elective craniotomy. This study investigates whether sex-related differences exist in frequency of postoperative complications in patients who underwent elective craniotomy for intracranial lesion. Material and Methods: All consecutive patients who underwent an elective intracranial procedure over a 2-year period at our center were eligible for inclusion in this retrospective study. Demographic data, comorbidities, frequency of postoperative complications at 24 hours following surgery and at discharge, and hospital length of stay were compared among females and males. Results: Overall, 664 patients were considered for the analysis. Of those, 339 (50.2%) were females. Demographic data were comparable among females and males. More females than males suffered from allergic, muscular, and rheumatic disorders. No differences in frequency of postoperative complications at 24 hours after surgery and at discharge were observed among females and males. Similarly, the hospital length of stay was comparable. Conclusions: In the present study, no sex-related differences in frequency of early postoperative complications and at discharge following elective craniotomy for intracranial lesions were observed.

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Sex Differences in In-hospital Complications Among Older Adults After Traumatic Brain Injury

Cited by 6 publications

References 33 publications

Sex and age differences in isolated traumatic brain injury: a retrospective observational study

Sex and age differences in isolated traumatic brain injury: a retrospective observational study

Predictive Value of Vital Signs at Presentation in Individuals with Severe Traumatic Brain Injuries

Sex-related differences in postoperative complications following elective craniotomy for intracranial lesions: An observational study

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