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Differences between Men and Women in Treatment and Outcome after Traumatic Brain Injury

Research output: Contribution to journalJournal articleResearchpeer-review


  1. Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI): A CENTER-TBI Analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Børn med iskæmisk apopleksi

    Research output: Contribution to journalReviewpeer-review

  • Ana Mikolić
  • David van Klaveren
  • Joost Oude Groeniger
  • Eveline J A Wiegers
  • Hester F Lingsma
  • Marina Zeldovich
  • Nicole von Steinbüchel
  • Andrew I R Maas
  • Jeanine E Roeters van Lennep
  • Suzanne Polinder
  • CENTER-TBI Participants and Investigators
  • Daniel Kondziella (Member of study group)
  • Martin Ejler Fabricius (Member of study group)
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Traumatic brain injury (TBI) is a significant cause of disability, but little is known about sex and gender differences after TBI. We aimed to analyze the association between sex/gender, and the broad range of care pathways, treatment characteristics, and outcomes following mild and moderate/severe TBI. We performed mixed-effects regression analyses in the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, stratified for injury severity and age, and adjusted for baseline characteristics. Outcomes were various care pathway and treatment variables, and 6-month measures of functional outcome, health-related quality of life (HRQoL), post-concussion symptoms (PCS), and mental health symptoms. The study included 2862 adults (36% women) with mild (mTBI; Glasgow Coma Scale [GCS] score 13-15), and 1333 adults (26% women) with moderate/severe TBI (GCS score 3-12). Women were less likely to be admitted to the intensive care unit (ICU; odds ratios [OR] 0.6, 95% confidence interval [CI]: 0.4-0.8) following mTBI. Following moderate/severe TBI, women had a shorter median hospital stay (OR 0.7, 95% CI: 0.5-1.0). Following mTBI, women had poorer outcomes; lower Glasgow Outcome Scale Extended (GOSE; OR 1.4, 95% CI: 1.2-1.6), lower generic and disease-specific HRQoL, and more severe PCS, depression, and anxiety. Among them, women under age 45 and above age 65 years showed worse 6-month outcomes compared with men of the same age. Following moderate/severe TBI, there was no difference in GOSE (OR 0.9, 95% CI: 0.7-1.2), but women reported more severe PCS (OR 1.7, 95% CI: 1.1-2.6). Men and women differ in care pathways and outcomes following TBI. Women generally report worse 6-month outcomes, but the size of differences depend on TBI severity and age. Future studies should examine factors that explain these differences.

Original languageEnglish
JournalJournal of Neurotrauma
Issue number2
Pages (from-to)235-251
Number of pages17
Publication statusPublished - 15 Jan 2021

    Research areas

  • care pathway, outcomes, sex differences, traumatic brain injury, treatment

ID: 61291360