Acute predictors for mortality after severe TBI in Spain: Gender differences and clinical data

Brain Inj. 2015;29(12):1439-44. doi: 10.3109/02699052.2015.1071428. Epub 2015 Aug 21.

Abstract

Objective: The main objective of this study is to determine whether gender affects global mortality and functional outcome after severe traumatic brain injury (TBI).

Methods: This retrospective cohort study included 629 patients with severe TBI (14.9% female) admitted to the ICU of a university hospital. Patients were split into gender groups to study potential differences in global mortality and functional outcome at ICU discharge and 6 months post-trauma using the GOS. The following variables were analysed: age, intracranial injury, injury mechanism, injury severity, factors contributing to secondary brain injury, monitoring level, treatment, complications, length of stay in the ICU and cause of death.

Results: No differences were found between gender groups in neuromonitoring level or surgical procedures. Women had higher APACHE II scores, a higher incidence of pre-hospital hypotension, anaemia and transfusion and higher mortality rates in the ICU (OR = 1.74; 95% CI = 1.09-2.77) and 6 months post-trauma (OR = 1.65; 95% CI = 1.02-2.67). There were no significant differences in functional outcome at ICU discharge or 6 months post-injury. The multivariate analysis did not show gender as an independent predictive factor in mortality after severe TBI.

Conclusion: In this study, gender was not found to be an independent predictor for poorer outcome after severe TBI.

Keywords: Death; emergency care; gender; head injury; neurocritical care; outcome; traumatic brain injury.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Brain Injuries / mortality*
  • Cohort Studies
  • Female
  • Forecasting
  • Glasgow Coma Scale
  • Glasgow Outcome Scale
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sex Factors*
  • Spain
  • Young Adult