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Is there a Sex Difference in the Course Following Traumatic Brain Injury?

University of Washington, Seattle, kirkness{at}u.washington.edu

Robert L. Burr, MSEE, PhD

University of Washington, Seattle

Pamela H. Mitchell, PhD, RN, FAAN

University of Washington, Seattle

David W. Newell, MD

Department of Neurological Surgery at the University of Washington, Seattle

Traumatic brain injury (TBI) is a significant cause of death and disability in the United States. Sex has not been thoroughly examined as a factor that may influence outcome following TBI. Clinical studies involving humans that have focused on sex and TBI outcome have yielded inconclusive results, yet sex-related physiologic differences have been demonstrated in animal studies. The purpose of this study is to examine the interaction of sex and age in relation to outcome at 3 and 6 months postinjury in a population of individuals with TBI. The sample includes 157 subjects (124 males, 33 females), 16 to 89 years of age, admitted to a level 1 trauma center following TBI. Physiologic data and information about injury severity and clinical course were gathered during hospitalization. Outcome was assessed at 3 and 6 months postinjury using the Extended Glasgow Outcome Scale (GOSE) and Functional Status Examination (FSE). In this sample, there was a significant relationship between sex and age with respect to functional outcome at 6 months following TBI, controlling for initial injury severity. Females age 30 years or older had significantly poorer outcome as measured by the GOSE (P = 0.031) and the FSE (P = 0.037) than either males or younger females. There was also a very different rate of recovery, with women age 30 years and older, on average, showing no improvement between 3 and 6 months postinjury. Further study is needed to elucidate the reasons why sex may affect outcome following TBI.

Key Words: traumatic brain injury • sex • functional outcome

Biological Research For Nursing, Vol. 5, No. 4, 299-310 (2004)
DOI: 10.1177/1099800404263050


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