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Gender and age effects on outcome after pediatric traumatic brain injury
Wynne E Morrison1, José J Arbelaez, James C Fackler
1University of Maryland School of Medicine, Baltimore, MD, USA.
Objective:
To evaluate whether girls have better outcomes after traumatic brain injury than boys.
Design:
Retrospective cohort study.
Setting:
University hospital.
Patients:
A 16,586 patient subset of the National Pediatric Trauma Registry with nonpenetrating traumatic brain injury.
Interventions:
Retrospective review.
Measurements And Main Results:
The patients were subdivided by age into prepubertal (0-7 yrs), indeterminate pubertal (8-12 yrs), and probable pubertal (13-19 yrs). All analyses were adjusted for injury severity using the Injury Severity Score. Outcome variables were in-hospital death rate, intensive care unit length of stay, total length of stay, discharge to home vs. rehabilitation, and functional status at discharge. Overall, 6.1% of girls and 5.3% of boys died. A higher proportion of girls were injured in motor vehicle crashes. Gender did not have a significant effect on in-hospital mortality rate after adjustment for age, Injury Severity Score, and motor vehicle crashes. Boys had a shorter intensive care unit length of stay (p =.027). There were no statistically significant differences between boys and girls in total hospital length of stay, functional outcome, and discharge location, although for every outcome there was a trend toward girls doing worse.
Conclusions:
There is evidence from this large study that girls do not have a better outcome after pediatric traumatic brain injury than boys, with a suggestion that girls may do worse.
