Traumatic Brain Injury Outcomes in Pre- and Post- Menopausal Females Versus Age-Matched Males
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.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Another large, multi-center study found lower mortality in women than men above 50 years of age.
“Another large, multi-center study found lower mortality in women than men above 50 years of age. 72”
From Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know (2019) · cites this paper as [72]
Cites
Evaluating trauma care: the TRISS method. Trauma Score and the Injury Severity Score.
Boyd, C. R., Tolson, M. A., & Copes, W. S. (1987) · PubMed · Cited by 1,954 · see citing works
BOYD, C. R., Tolson, M. A., & Copes, W. S. (1987) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-198704000-00005 · Cited by 1,843 · see citing works
Goodman, Y., Bruce‐Keller, A. J., Cheng, B., & Mattson, M. P. (1996) · Journal of Neurochemistry · doi:10.1046/j.1471-4159.1996.66051836.x · Cited by 830 · see citing works
Traumatic Brain Injury in Older Adults: Epidemiology, Outcomes, and Future Implications
Thompson, H. J., McCormick, W. C., & Kagan, S. H. (2006) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2006.00894.x · Cited by 685 · see citing works
Kimura, D. (1992) · Scientific American · doi:10.1038/scientificamerican0992-118 · Cited by 664 · see citing works
Roof, R. L., & Hall, E. D. (2000) · Journal of Neurotrauma · doi:10.1089/neu.2000.17.367 · Cited by 652 · see citing works
Neuroprotective effects of estrogens: potential mechanisms of action
Green, P. S., & Simpkins, J. W. (2000) · International Journal of Developmental Neuroscience · doi:10.1016/s0736-5748(00)00017-4 · Cited by 523 · see citing works
Do women fare worse: a metaanalysis of gender differences in traumatic brain injury outcome
Farace, E., & Alves, W. M. (2000) · Journal of neurosurgery · doi:10.3171/jns.2000.93.4.0539 · Cited by 446 · see citing works
Anterior Pituitary Dysfunction in Survivors of Traumatic Brain Injury
Agha, A., Rogers, B., Sherlock, M., O’Kelly, P., Tormey, W., Phillips, J., & Thompson, C. J. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0511 · Cited by 390 · cited 1× · see citing works
“…hormonal cycles and produces an estrogen or progesterone withdrawal syndrome in pre-but not post-menopausal females (Fleischer et al., 1978; Kosteljanetz et al., 1981; Woolf et al., 1986; Spratt et al., 1992; Murphy et al., 2000; Agha et al., 2004; Dimopoulou et al., 2004; Land-gren et al., 2004).”
Innate Gender-based Proclivity in Response to Cytotoxicity and Programmed Cell Death Pathway
Du, L., Bayır, H., Lai, Y., Zhang, X., Kochanek, P. M., Watkins, S. C., Graham, S. H., & Clark, R. S. B. (2004) · Journal of Biological Chemistry · doi:10.1074/jbc.m405461200 · Cited by 351 · see citing works
Progesterone and allopregnanolone reduce inflammatory cytokines after traumatic brain injury
HE, J., EVANS, C., Hoffman, S. D., Oyesiku, N. M., & Stein, D. G. (2004) · Experimental Neurology · doi:10.1016/j.expneurol.2004.06.008 · Cited by 332 · see citing works
Progesterone protects against lipid peroxidation following traumatic brain injury in rats
Roof, R. L., Hoffman, S. W., & Stein, D. G. (1997) · Molecular and Chemical Neuropathology · doi:10.1007/bf02815156 · Cited by 317 · see citing works
Sex, sexual orientation and sex hormones influence human cognitive function
Kimura, D. (1996) · Current Opinion in Neurobiology · doi:10.1016/s0959-4388(96)80081-x · Cited by 316 · see citing works
McCauley, S. R., Boake, C., Levin, H. S., Contant, C. F., & Song, J. (2001) · Journal of Clinical and Experimental Neuropsychology · doi:10.1076/jcen.23.6.792.1016 · Cited by 265 · see citing works
Djebaı̈li, M., Hoffman, S. W., & Stein, D. G. (2003) · Neuroscience · doi:10.1016/j.neuroscience.2003.09.023 · Cited by 256 · see citing works
Progesterone Rapidly Decreases Brain Edema: Treatment Delayed up to 24 Hours Is Still Effective
Roof, R. L., Duvdevani, R., Heyburn, J. W., & Stein, D. G. (1996) · Experimental Neurology · doi:10.1006/exnr.1996.0063 · Cited by 244 · see citing works
Sex differences in cerebral organization for speech and praxic functions.
Kimura, D. (1983) · Canadian Journal of Psychology/Revue Canadienne de Psychologie · doi:10.1037/h0080696 · Cited by 238 · see citing works
The Postconcussion Syndrome and the Sequelae of Mild Head Injury
Evans, R. W. (1992) · Neurologic Clinics · doi:10.1016/s0733-8619(18)30182-8 · Cited by 238 · see citing works
Roof, R. L., & Hall, E. D. (2000) · Journal of Neurotrauma · doi:10.1089/neu.2000.17.1155 · Cited by 233 · see citing works
Altered osmotic thresholds for vasopressin secretion and thirst in human pregnancy
Davison, J. M., Gilmore, E. A., Durr, J., Robertson, G. L., & Lindheimer, M. D. (1984) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.1984.246.1.f105 · Cited by 225 · see citing works
Female TBI patients recover better than males
Groswasser, Z., Cohen, M., & Keren, O. (1998) · Brain Injury · doi:10.1080/026990598122197 · Cited by 216 · see citing works
Aromatase Cytochrome P450 and Extragonadal Estrogen Play a Role in Ischemic Neuroprotection
McCullough, L. D., Blizzard, K. K., Simpson, E. R., Öz, O. K., & Hurn, P. D. (2003) · Journal of Neuroscience · doi:10.1523/jneurosci.23-25-08701.2003 · Cited by 214 · see citing works
Bramlett, H. M., & Dietrich, W. D. (2001) · Journal of Neurotrauma · doi:10.1089/089771501750451811 · Cited by 213 · see citing works
Cytokines Act within the Brain to Inhibit Luteinizing Hormone Secretion and Ovulation in the Rat*
RIVIER, C. L., & Vale, W. (1990) · Endocrinology · doi:10.1210/endo-127-2-849 · Cited by 203 · see citing works
Holbrook, T. L., & Hoyt, D. B. (2004) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000109758.75406.f8 · Cited by 202 · see citing works
Self-citationMarked Gender Effect on Lipid Peroxidation after Severe Traumatic Brain Injury in Adult Patients
Bayir, H., Marion, D. W., Puccio, A. M., Wisniewski, S. R., Janesko, K. L., Clark, R. S. B., & Kochanek, P. M. (2004) · Journal of Neurotrauma · doi:10.1089/089771504772695896 · Cited by 194 · see citing works
Sex Differences in Brain Organization for Verbal and Non-Verbal Functions
Kimura, D., & Harshman, R. A. (1984) · Progress in brain research · doi:10.1016/s0079-6123(08)64452-0 · Cited by 187 · see citing works
Shear, D. A., Galani, R., Hoffman, S. W., & Stein, D. G. (2002) · Experimental Neurology · doi:10.1006/exnr.2002.8020 · Cited by 179 · see citing works
Estrogen Replacement Therapy May Protect against Intellectual Decline in Postmenopausal Women
Kimura, D. (1995) · Hormones and Behavior · doi:10.1006/hbeh.1995.1022 · Cited by 171 · see citing works
Landgren, B.-M., Collins, A., Csemiczky, G., Burger, H., Baksheev, L., & Robertson, D. M. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-030824 · Cited by 171 · see citing works
Levin, H. S., Brown, S. A., Song, J., McCauley, S. R., Boake, C., Contant, C. F., Goodman, H. S., & Kotrla, K. J. (2001) · Journal of Clinical and Experimental Neuropsychology · doi:10.1076/jcen.23.6.754.1021 · Cited by 170 · see citing works
Emerson, C. S., Headrick, J. P., & Vink, R. (1993) · Brain Research · doi:10.1016/0006-8993(93)90778-l · Cited by 154 · see citing works
Wagner, A. K., Bayır, H., Ren, D., Puccio, A. M., ZAFONTE, R. D., & Kochanek, P. M. (2004) · Journal of Neurotrauma · doi:10.1089/089771504322778596 · Cited by 152 · see citing works
He, J., Hoffman, S. W., & Stein, D. G. (2004) · Restorative Neurology and Neuroscience · doi:10.3233/rnn-2004-00243 · Cited by 146 · see citing works
Wagner, A. K., Willard, L. A., Kline, A. E., Wenger, M. K., Bolinger, B. D., Ren, D., Zafonte, R. D., & Dixon, C. E. (2004) · Brain Research · doi:10.1016/j.brainres.2003.11.027 · Cited by 141 · see citing works
Estrogen Hormones Reduce Lipid Peroxidation in Cells and Tissues of the Central Nervous System
Vedder, H., Anthes, N., Stumm, G., Würz, C., Behl, C., & Krieg, J. C. (1999) · Journal of Neurochemistry · doi:10.1046/j.1471-4159.1999.0722531.x · Cited by 134 · see citing works
Spinedi, E., Suescun, M. O., Hadid, R., Daneva, T., & Gaillard, R. C. (1992) · Endocrinology · doi:10.1210/en.131.5.2430 · Cited by 132 · see citing works
Estrogen influences osmotic secretion of AVP and body water balance in postmenopausal women
Stachenfeld, N. S., Dipietro, L., Palter, S. F., & Nadel, E. R. (1998) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.1998.274.1.r187 · Cited by 132 · see citing works
Spratt, D. I., Bigos, S. T., Beitins, I., Cox, P., Longcope, C., & Orav, J. (1992) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.75.6.1464665 · Cited by 118 · see citing works
Wilson, M. A. (1992) · Brain Research Bulletin · doi:10.1016/0361-9230(92)90022-p · Cited by 116 · see citing works
Sexual dimorphism and developmental regulation of substantia nigra function
Velı́šková, J., & Moshé, S. L. (2001) · Annals of Neurology · doi:10.1002/ana.1248 · Cited by 112 · see citing works
Kupina, N. C., Detloff, M. R., Bobrowski, W. F., Snyder, B. J., & Hall, E. D. (2003) · Experimental Neurology · doi:10.1016/s0014-4886(02)00048-1 · Cited by 111 · see citing works
Gannon, C. J., Napolitano, L. M., Pasquale, M. D., Tracy, K. J., & McCarter, R. (2002) · Journal of the American College of Surgeons · doi:10.1016/s1072-7515(02)01187-0 · Cited by 107 · see citing works
Cytokines and the hypothalamic—pituitary—ovarian—endometrial axis
TABIBZADEH, S. S. (1994) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a138621 · Cited by 106 · see citing works
Murphy, S. J., Littleton‐Kearney, M. T., & Hurn, P. D. (2002) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1097/01.wcb.0000037990.07114.07 · Cited by 104 · see citing works
Progesterone Exacerbates Striatal Stroke Injury in Progesterone-Deficient Female Animals
Murphy, S. J., Traystman, R. J., & Hurn, P. D. (2000) · Stroke · doi:10.1161/01.str.31.5.1173 · Cited by 102 · see citing works
Grachev, I. D., & Apkarian, A. V. (2000) · NeuroImage · doi:10.1006/nimg.2000.0557 · Cited by 100 · see citing works
Does Sexual Dimorphism Influence Outcome of Traumatic Brain Injury Patients? The Answer Is No!
Coimbra, R. S. M., Hoyt, D. B., Potenza, B. M., Fortlage, D. A., & Hollingsworth-Fridlund, P. (2003) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000058314.31655.5f · Cited by 92 · see citing works
Self-citationDimopoulou, I., Tsagarakis, S., Θεοδωρακοπούλου, Μ., Douka, E., Zervou, M., Kouyialis, A. T., Thalassinos, N., & Roussos, C. (2004) · Intensive Care Medicine · doi:10.1007/s00134-004-2257-x · Cited by 91 · see citing works
Gender and age effects on outcome after pediatric traumatic brain injury*
Morrison, W. E., Arbelaez, J. J., Fackler, J. C., Maio, A. D., & Paidas, C. N. (2004) · Pediatric Critical Care Medicine · doi:10.1097/01.pcc.0000112373.71645.2a · Cited by 90 · see citing works
Depression amongst outpatients with traumatic brain injury
Glenn, M. B., O’Neil-Pirozzi, T. M., Goldstein, R. C., Burke, D. T., & Jacob, L. (2001) · Brain Injury · doi:10.1080/02699050010025777 · Cited by 90 · see citing works
Effect of ovarian sex steroids on osmoregulation and vasopressin secretion in the rat
Barron, W. M., Schreiber, J., & Lindheimer, M. D. (1986) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1986.250.4.e352 · Cited by 89 · see citing works
Subtle Symptoms Associated with Self-Reported Mild Head Injury
Segalowitz, S. J., & Lawson, S. (1995) · Journal of Learning Disabilities · doi:10.1177/002221949502800507 · Cited by 87 · see citing works
Employment After Traumatic Brain Injury: Differences Between Men and Women
Corrigan, J. D., Lineberry, L. A., Komaroff, E., Langlois, J. A., Selassie, A. W., & Wood, K. D. (2007) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2007.08.006 · Cited by 84 · see citing works
Deleterious effect of β-estradiol in a rat model of transient forebrain ischemia
Harukuni, I., Hurn, P. D., & Crain, B. J. (2001) · Brain Research · doi:10.1016/s0006-8993(01)02278-8 · Cited by 83 · see citing works
Russell, S. H., Small, C. J., Stanley, S., Franks, S., Ghatei, M. A., & Bloom, S. R. (2001) · Journal of Neuroendocrinology · doi:10.1046/j.1365-2826.2001.00632.x · Cited by 78 · see citing works
Xiong, Y., Mahmood, A., Lu, D., Qu, C., Goussev, A. V., Schallert, T., & Chopp, M. (2007) · Brain Research · doi:10.1016/j.brainres.2007.09.052 · Cited by 74 · see citing works
Estradiol Exacerbates Hippocampal Damage in a Model of Preterm Infant Brain Injury
Nuñez, J. L., & McCarthy, M. M. (2003) · Endocrinology · doi:10.1210/en.2002-220840 · Cited by 72 · see citing works
Influence of gender and brain region on neurosteroid modulation of GABA responses in rats
Wilson, M. A., & Biscardi, R. (1997) · Life Sciences · doi:10.1016/s0024-3205(97)00110-0 · Cited by 69 · see citing works
Gender Differences in Agitation After Traumatic Brain Injury
Kadyan, V., Mysiw, W. J., Bogner, J. A., Corrigan, J. D., Fugate, L. P., & Clinchot, D. M. (2004) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/01.phm.0000140790.30468.f4 · Cited by 69 · see citing works
Woolf, P. D., Hamill, R. W., McDonald, J. V., Lee, L. A., & Kelly, M. M. (1986) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1986.tb01691.x · Cited by 67 · see citing works
Ovtscharoff, W. A., Eusterschulte, B., Zienecker, R., Reisert, I., & Pilgrim, C. (1992) · The Journal of Comparative Neurology · doi:10.1002/cne.903230212 · Cited by 61 · see citing works
Hypothalamic hypothyroidism and hypogonadism in prolonged traumatic coma
Fleischer, A. S., Rudman, D. R., Payne, N. S., & Tindall, G. T. (1978) · Journal of neurosurgery · doi:10.3171/jns.1978.49.5.0650 · Cited by 61 · see citing works
The Effects of Early Post-Traumatic Hyperthermia in Female and Ovariectomized Rats
Suzuki, T., Bramlett, H. M., Ruenes, G., & Dietrich, W. D. (2004) · Journal of Neurotrauma · doi:10.1089/0897715041526186 · Cited by 59 · see citing works
Women's Advantage on Verbal Memory is Not Restricted to Concrete Words
Kimura, D., & Clarke, P. G. (2002) · Psychological Reports · doi:10.2466/pr0.2002.91.3f.1137 · Cited by 59 · see citing works
Clinical Predictors of Posttraumatic Stress Disorder After Closed Head Injury in Children
Gerring, J. P., Slomine, B. S., Vasa, R. A., Grados, M. A., Chen, A., Rising, W., Christensen, J. R., DENCKLA, M. B., & Monique Ernst, D. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200202000-00009 · Cited by 58 · see citing works
Predictors of Neuropsychological Test Performance After Pediatric Traumatic Brain Injury
Donders, J., & Nesbit-Greene, K. (2004) · Assessment · doi:10.1177/1073191104268914 · Cited by 53 · see citing works
Sexual and hypothalamic dysfunction in the postconcussional syndrome
Kosteljanetz, M., Jensen, T. S., Nørgård, B., Lunde, I., Jensen, P. B., & Johnsen, S. G. (2009) · Acta Neurologica Scandinavica · doi:10.1111/j.1600-0404.1981.tb00769.x · Cited by 51 · see citing works
Knöferl, M. W., Angele, M. K., Schwacha, M. G., Samy, T. S. A., Bland, K. I., & Chaudry, I. H. (2003) · Cellular Immunology · doi:10.1016/s0008-8749(03)00081-9 · Cited by 41 · see citing works
Lessons from epidemiologic studies in clinical trials of traumatic brain injury
Farin, A., & Marshall, L. F. (2004) · Springer eBooks · doi:10.1007/978-3-7091-0603-7_14 · Cited by 40 · see citing works
Sex Differences in Recall of Real or Nonsense Words
Kimura, D., & Seal, B. N. (2003) · Psychological Reports · doi:10.2466/pr0.2003.93.1.263 · Cited by 36 · see citing works
Adaptive Interactions between Cytokines and the Hypothalamic‐Pituitary‐Gonadal Axis
Cannon, J. G. (1998) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1998.tb08330.x · Cited by 31 · see citing works
Influence of Gender and Gonadectomy on Bicuculline-Induced Convulsions and on GABAA Receptors
Bujas, M., Peričić, D., & Jazvinšćak, M. (1997) · Brain Research Bulletin · doi:10.1016/s0361-9230(97)00027-0 · Cited by 28 · see citing works
Theas, M. S., Pisera, D. A., Duvilanski, B. H., et al. (2000) · Endocrine · doi:10.1385/endo:12:3:249 · Cited by 20 · see citing works
Kldi, I., & Berta, A. (2004) · PubMed · doi:10.5301/ejo.2008.1363 · Cited by 17 · see citing works
McCauley, L. D., & Gee, K. W. (1995) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)12199-x · Cited by 17 · see citing works
Káldi, I., & Berta, A. (2004) · European Journal of Ophthalmology · doi:10.1177/112067210401400405 · Cited by 15 · see citing works
SEX DIFFERENCES IN RECALL OF REAL OR NONSENSE WORDS
Kimura, D. (2003) · Psychological Reports · doi:10.2466/pr0.93.5.263-264 · Cited by 12 · see citing works
WOMEN'S ADVANTAGE ON VERBAL MEMORY IS NOT RESTRICTED TO CONCRETE WORDS
Kimura, D. (2002) · Psychological Reports · doi:10.2466/pr0.91.8.1137-1142 · Cited by 8 · see citing works
Are men's and women's brains different?
Jones, F. S. (1998) · PubMed · Cited by 4 · see citing works
Garcia, E. F., Baliwas, B. J., Tran, T. T. T., et al. (2003) · PubMed · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know
Gupte, R. P., Brooks, W. M., Vukas, R. R., Pierce, J. D., & Harris, J. L. (2019) · Journal of Neurotrauma · doi:10.1089/neu.2018.6171 · Cited by 533 · see citing works
The Effect of Gender on Patients With Moderate to Severe Head Injuries
Berry, C., Ley, E. J., Tillou, A., Cryer, G., Margulies, D. R., & Salim, A. (2009) · Journal of Trauma: Injury, Infection & Critical Care · doi:10.1097/ta.0b013e3181ba3354 · Cited by 197 · see citing works
Sex-related responses after traumatic brain injury: Considerations for preclinical modeling
Späni, C. B., Braun, D. J., & Van Eldik, L. J. (2018) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2018.03.006 · Cited by 195 · see citing works
Traumatic brain injury: Does gender influence outcomes?
Munivenkatappa, A., Agrawal, A., Shukla, D., Kumaraswamy, D., & Devi, B. (2016) · International Journal of Critical Illness and Injury Science · doi:10.4103/2229-5151.183024 · Cited by 141 · see citing works
Severe traumatic brain injury: is there a gender difference in mortality?
Ottochian, M., Salim, A., Berry, C., Chan, L. S., Wilson, M. T., & Margulies, D. R. (2009) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2008.09.008 · Cited by 87 · see citing works
- 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
- Publisher
- SAGE Publications
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review