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Mild and Moderate Traumatic Brain Injury and Gender-Based Critical Care Outcomes

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Abstract

Background

Traumatic brain injury (TBI) is a major contributor to death and complications. Previous studies have identified gender disparities among trauma patients. This study aims to examine the association between gender and outcomes in TBI patients.

Study design and methods

Review of our trauma registry: Patients were classified into groups according to their gender. Demographics extracted from the registry included age, injury severity score (ISS), Glasgow Coma Score (GCS), head abbreviated injury score (AIS), and the presence of an epidural hematoma (EDH). The primary outcome was mortality; secondary outcomes included ICU length of stay (ICU-LOS), craniotomy rate, ventilator-associated pneumonia (VAP), and readmission rates. Significance was defined as p < 0.05.

Results

Nine hundred and thirty-five patients with TBI were studied: 62.1% (n = 581) were male and 37.9% (n = 354) were female. There were no differences in GCS, ISS, and head AIS. Males were younger [53 (IQR 30–77) vs. 76 (IQR 49.25–84), p < 0.05] and were more likely to have an EDH (9.6% vs. 4.8%, p = 0.007). Males also had a longer median ICU-LOS [4 days (IQR 2–8) vs. 3 days (IQR 0–5), p < 0.05] and were significantly more likely to require a craniotomy (44.6% vs. 19.2%, p < 0.001). In addition, males were more likely to develop VAP (4.1% vs. 0.8%, p = 0.004). Predicted survival (79.2% vs. 72.9%) and actual mortality rates (4.5% vs. 4.5%) were similar in both genders (p > 0.05).

Conclusion

In the context of our study, male patients with TBI were significantly younger, were more likely to sustain an EDH, and were also more likely to require a craniotomy, but mortality rates between both genders were similar. The male gender was also associated with a significantly increased ICU-LOS and VAP.

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Authors and Affiliations

  1. Department of Surgery, Kendall Regional Medical Center, 11750 Bird Road, Miami, FL, 33175, USA

    Adel Elkbuli, Zachary Smith, Saamia Shaikh, Shaikh Hai, Mark McKenney & Dessy Boneva

  2. University of South Florida, Tampa, FL, USA

    Mark McKenney & Dessy Boneva

Authors
  1. Adel Elkbuli
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  2. Zachary Smith
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  3. Saamia Shaikh
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  4. Shaikh Hai
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  5. Mark McKenney
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  6. Dessy Boneva
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Correspondence to Adel Elkbuli.

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Elkbuli, A., Smith, Z., Shaikh, S. et al. Mild and Moderate Traumatic Brain Injury and Gender-Based Critical Care Outcomes. World J Surg 44, 1492–1497 (2020). https://doi.org/10.1007/s00268-020-05381-w

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  • DOI: https://doi.org/10.1007/s00268-020-05381-w

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