Cited by 132Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchTrauma and Emergency Care Studies

Traumatic Brain Injury Outcomes in Pre- and Post- Menopausal Females Versus Age-Matched Males

Davis, Daniel P., Douglas, Danielle J., Smith, Wendy, Sise, Michael J., Vilke, Gary M., Holbrook, Troy L., Kennedy, Frank, Eastman, A. Brent +2 more·2006·Journal of Neurotrauma

Abstract

Gender differences in outcomes from major trauma have been described previously, and exogenous female hormone administration appears to be neuroprotective following traumatic brain injury (TBI). This analysis explored outcomes in pre- and post-menopausal females versus age-matched males. A total of 13,437 patients (n = 3,178 females, n = 10,259 males) with moderate-to-severe TBI (head AIS > or = 3) were identified from our county trauma registry. Overall mortality was similar between males and females (22% for both). Logistic regression was used to compare gender outcome differences, with a separate analysis performed for premenopausal (< 50 years) versus postmenopausal (> or = 50 years) patients, and after stratification by decade of life. No statistically significant difference in outcomes was observed for pre-menopausal females versus males (odds ratio [OR] 1.06; 95% confidence interval [CI] 0.83, 1.35; p = 0.633), but outcomes were significantly better in postmenopausal females versus males (OR 0.63, 95% CI 0.48-0.81, p < 0.001) after adjusting for age, mechanism of injury, Glasgow Coma Scale (GCS), hypotension (SBP < or = 90 mm Hg), head Abbreviated Injury Score (AIS), and Injury Severity Score (ISS). Stratification by decade of life revealed the gender survival differential inflection point to occur between ages 40-49 (OR 1.06, 95% CI 0.66-1.71, p = 0.798) and ages 50-59 (OR 0.38, 95% CI 0.20-0.74, p = 0.005). In addition, Revised Trauma Score and Injury Severity Score (TRISS) was used to calculate probability of survival (PS); all patients were then stratified by decade of life, and males and females were compared with regard to mean survival differential (outcome - PS). The identical pattern of improved outcomes in post-menopausal but not pre-menopausal females versus age-matched males was observed. These data suggest that endogenous female sex hormone production is not neuroprotective.

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Crossref · 10.1089/neu.2006.23.140

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Authors
Davis, D. P., Douglas, D. J., Smith, W., Sise, M. J., Vilke, G. M., Holbrook, T. L., Kennedy, F., Eastman, A. B., Velky, T., & Hoyt, D. B.
Affiliations
  • University of California San Diego (US)
  • Scripps Mercy Hospital (US)
  • Sharp Memorial Hospital (US)
  • Scripps Memorial Hospital (US)
  • Palomar Medical Center (US)
Venue
Journal of Neurotrauma
Published
2006-02
Volume
23
Issue
2
Pages
140-148
ISSN
  • 0897-7151 (ISSN-L)
  • 1557-9042
OpenAlex
W2016262610
Cited by
132
References
81
Citations by year
2026: 11 · 2025: 2 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 15 · 2020: 10 · 2019: 12 · 2018: 9 · 2017: 4 · 2016: 4 · 2015: 7 · 2014: 3 · 2013: 3 · 2012: 2
FWCI
4.35
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Neurotrauma (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
Keywords
traumatic brain injury, sex differences, menopause, postmenopausal women, premenopausal women, female sex hormones, neuroprotection, survival outcomes, mortality, age-stratified analysis, TRISS, injury severity
MeSH terms
Adolescent, Adult, Age Factors, Aged, Brain Injuries, Female, Humans, Male, Middle Aged, Retrospective Studies, Sex Factors, Trauma Severity Indices, Survival Rate, Outcome Assessment, Health Care, Premenopause, Postmenopause

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