Sex Differences in the Outcomes of Mild Traumatic Brain Injury in Children Presenting to the Emergency Department

Abstract

Mild traumatic brain injuries (mTBI) put children and adolescents at risk for short and long-term health risks. The purpose of this study was to evaluate sex differences in post-acute outcomes among children and adolescents presenting to the Emergency Department (ED) for mTBI. The study is a secondary analysis of a de-identified dataset which was drawn from a concurrent cohort, prospective, and longitudinal study design that included 8 to 16 year-old children with mTBI and a comparison group of children with mild orthopedic injuries (OI) not involving the head. Participants were recruited and completed an initial assessment during their initial visit to the ED. They returned for a post-acute assessment within two weeks of injury. Outcomes of interest included parent and child ratings of somatic and cognitive symptoms, and standardized tests of neurocognitive functioning and balance. Girls reported a significantly larger increase in somatic symptoms post-mTBI than boys, using OI as a comparison group. In contrast, no significant sex differences were found for child ratings of cognitive symptoms, parent ratings of somatic or cognitive symptoms, neurocognitive functioning, or balance. The results suggest only limited sex differences in post-acute outcomes of mTBI in a pediatric ED population. The findings have potential implications for clinical and public health which include being used to guide implementation of policies related to pediatric injury prevention. Future research is needed to examine how rule and equipment changes can improve the sex differences found in somatic symptoms after mTBI.

The Relationship between Head Injury and Behaviour Problems for Children in Aotearoa New Zealand: The Impact of Individual, Whānau and Societal Factors

“…These results are consistent with the findings of Yeates et al (2022), who examined the outcomes of TBI in preadolescent children and discovered that biological sex did not have a moderating effect. However, the findings were still unexpected given a review by Valera et al (2021).…”

“…The preadolescent age of the children included in this study is a crucial factor to consider when examining biological sex-based outcomes in the context of TBI (Yeates et al, 2022).…”

Longitudinal trajectories of posttraumatic headache after pediatric mild traumatic brain injury

“…As previously described (13), consent was obtained for 315 children who completed the initial (emergency department) assessment; 217 (69%), 159 (50%), and 143 (45%) of those children returned for the 10-day, three-month, and six-month assessments, respectively. This rate of attrition is consistent with other pediatric mTBI studies (12,23).…”

“…Both of these factors are also associated with pediatric headache disorders (24,26). In general, more somatic symptoms are reported in girls (through self- or parent report) after traumatic injury (13), and girls exhibit greater risk of protracted recovery following mTBI (2,6,28). We did not investigate whether sex moderated age-related differences in this study, given limited statistical power.…”

“…Data were drawn from a large, prospective, longitudinal cohort study of outcomes following pediatric mTBI (13). Children aged 8–16.99 years were recruited within 24 hours of sustaining an mTBI or a mild OI during initial emergency department visits at two children’s hospitals in the USA between 2014 and 2017.…”