Sex Differences in In-hospital Complications Among Older Adults After Traumatic Brain Injury

Area of Science:

• Gerontology
• Neuroscience
• Public Health

Background:

• Older adults experience severe outcomes following traumatic brain injury (TBI), including high hospitalization and mortality rates.
• Non-neurological complications significantly influence TBI patient outcomes.
• Existing research suggests potential sex-based differences in TBI recovery, with women possibly having better outcomes.

Purpose of the Study:

• To investigate sex-based disparities in in-hospital complications among older adults (aged 65 and above) who have sustained a traumatic brain injury.
• To provide crucial data on how age and sex interact to influence TBI complication rates in elderly patients.

Main Methods:

• A retrospective cohort study design was employed, analyzing data from adults aged 65 years and older treated for moderate to severe TBI.
• Patient data were extracted from the R Adams Cowley Shock Trauma Center registry between 1996 and 2012.
• In-hospital complications were identified using International Classification of Disease, Ninth Revision, Clinical Modification codes, with specific criteria for TBI severity and injury mechanism.

Main Results:

• The study included 2511 patients, with 51.1% being men. Overall, 25.1% of patients developed in-hospital complications.
• Men were significantly more likely than women to experience in-hospital complications (28.1% vs. 22.0%, P < 0.001).
• Adjusted analysis confirmed that men had a 23% increased risk of any in-hospital complication compared to women (Hazard Ratio: 1.23; 95% CI: 1.05-1.44).

Conclusions:

• Older men are at a higher risk for developing in-hospital complications following traumatic brain injury compared to older women.
• These findings underscore the importance of considering sex as a critical factor in managing TBI in the geriatric population.