The Association Between Gender and Clinical Outcomes in Patients With Moderate to Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Authors

Tessa Breeding, Nova Southeastern UniversityFollow
Brian Martinez, Nova Southeastern UniversityFollow
Joshua Katz, Nova Southeastern UniversityFollow
Hazem Nasef, Nova Southeastern UniversityFollow
Radleigh G. Santos, Nova Southeastern UniversityFollow
Tracy Zito, Orlando Regional Medical Center
Adel Elkbuli, Orlando Regional Medical Center

Document Type

Article

Publication Date

3-2024

Publication Title

Journal of Surgical Research

Keywords

Gender disparities, Mortality rates, Trauma outcomes, Traumatic brain injury

ISSN

0022-4804

Volume

295

First Page

791

Last Page

799

Abstract

Introduction

Traumatic brain injuries (TBIs) are a significant cause of morbidity and mortality in the United States. but have a disproportionate impact on patients based on gender. This systematic review and meta-analysis aim to compare gender differences in clinical outcomes between male and female adult trauma patients with moderate and severe TBI.

Methods

Studies assessing gender differences in outcomes following TBIs on PubMed, Google Scholar, EMBASE, and ProQuest were searched. Meta-analysis was performed for outcomes including in-hospital mortality, hospital length of stay, intensive care unit length of stay, and Glasgow outcome scale (GOS) at 6 mo.

Results

Eight studies were included for analysis with 26,408 female and 63,393 male patients. Meta-analysis demonstrated that males had a significantly lower risk of mortality than females (RR: 0.88; 95% CI 0.78, 0.99; P = 0.0001). Females had a shorter hospital length of stay (mean difference −1.4 d; 95% CI - 1.6 d, −1.2 d). No significant differences were identified in intensive care unit length of stay (mean difference −3.0 d; 95% CI -7.0 d, 1.1 d; P = 0.94) or GOS at 6 mo (mean difference 0.2 d; 95% CI -0.9 d, 1.4 d; P = 1).

Conclusions

Compared to male patients, female patients with moderate and severe TBI had a significantly higher in-hospital mortality risk. There were no significant differences in long-term outcomes between genders based on GOS at 6 mo. These findings warrant further investigation into the etiology of these gender disparities and their impact on additional clinical outcome measures.

Comments

ª 2023 Elsevier Inc. All rights reserved

NSUWorks Citation

Breeding, Tessa; Martinez, Brian; Katz, Joshua; Nasef, Hazem; Santos, Radleigh G.; Zito, Tracy; and Elkbuli, Adel, "The Association Between Gender and Clinical Outcomes in Patients With Moderate to Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis" (2024). Mathematics Faculty Articles. 363.
https://nsuworks.nova.edu/math_facarticles/363

DOI

10.1016/j.jss.2023.11.035