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Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Association Between Sex and Mortality After Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

Elise Beijer1,2,3, Floor J Mansvelder2, Romein W G Dujardin2

  • 1Department of Surgery, Section Trauma Surgery, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.

Neurocritical Care
|April 24, 2026
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Summary

Sex does not universally impact traumatic brain injury (TBI) mortality. The relationship between sex and TBI outcomes is context-dependent, varying by study and patient factors, not a simple biological association.

Keywords:
Brain injuriesMortalityNervous systemSex differencesTraumaWounds and injuries

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Area of Science:

  • Neuroscience
  • Public Health
  • Epidemiology

Background:

  • Traumatic brain injury (TBI) is a leading cause of death from trauma.
  • The impact of sex on TBI-related mortality is debated, with inconsistent findings.
  • Understanding sex differences in TBI mortality is vital for prognosis and tailored treatments.

Purpose of the Study:

  • To systematically review and meta-analyze existing literature on sex differences in TBI mortality.
  • To clarify the association between sex and mortality risk following traumatic brain injury.
  • To identify factors contributing to heterogeneity in reported sex-specific TBI outcomes.

Main Methods:

  • Systematic literature search across major databases (PubMed, Embase, Web of Science, Cochrane Library) without date restrictions.
  • Inclusion of observational studies with sex-stratified TBI mortality data.
  • Random-effects meta-analysis of 40 studies (over 1 million patients) using odds ratios, supplemented by subgroup, sensitivity, and meta-regression analyses.

Main Results:

  • Overall, no significant association was found between sex and TBI mortality (OR 0.99; 95% CI 0.90-1.09).
  • Substantial heterogeneity indicates that female mortality may be higher or lower depending on specific contexts.
  • Subgroup analyses by TBI type, age, or severity did not reveal significant differences; initial trends were not robust in sensitivity analyses.

Conclusions:

  • There is no inherent biological link between sex and TBI mortality.
  • The observed variations in sex-specific TBI mortality are context-dependent, influenced by study characteristics and patient populations.
  • Future research should focus on identifying specific clinical and biological contexts influencing sex-based outcomes for personalized TBI care.