Associations Between Sex, Pain Intensity, Quality of Life and Satisfaction with Life After Traumatic Brain Injury: Insights from FITBIR Data

Background and/or Objectives: To investigate the associations between sex and quality of life, satisfaction with life, and pain intrusiveness at the 2-week assessment after traumatic brain injury (TBI).

Design: Retrospective study using data from the Federal Interagency Traumatic Brain Injury Research (FITBIR) informatics system.

Setting : Multicenter study leveraging national TBI research datasets.

Participants : Individuals with TBI whose data was available at the 2-week assessment period in the FITBIR database.

Interventions: Not Applicable

Main Outcome Measures: Quality of life (QoL) was assessed using the 12-item Short Form Survey (SF-12; physical and mental component scores: PCS and MCS), satisfaction with Satisfaction with Life Scale scores (SWLS) and pain interference with Patient-Reported Outcomes Measurement Information System (PROMIS) V2 pain interference scaled T-score. Pain intensity was dichotomized (≤54:not intensive, ≥54:intensive), as were SWLS (≤20:not satisfied, ≥21 satisfied) and SF-12 Physical (PCS) and Mental (MCS) component scores (≤45:unsatisfactory, ≥45 satisfactory). The proportion of individuals with intensive pain, unsatisfactory QoL and less satisfaction between the two sexes was compared using Chi-Squared tests. Logistic Regression analyses estimated the odds of having more intensive pain, unsatisfactory QoL and being less satisfied in females.

Results: We found 1932 records for pain (32.8% females, n=633), 1934 records for SWLS scores (32.9% females, n=637), 423 records for PCS scores (33.3% female, n=141) and 414 records (32.1% female, n=133) for MCS scores. A greater proportion of females (p < 0.01) reported more intensive pain (39.3%,n=136,Χ2 (1)=8.2), less life satisfaction (36.7%,n=234,Χ2 (1)=8.2), and unsatisfactory MCS scores (43.6%,n=58,Χ2 (1)=8.4). Logistic regression analyses revealed females were 1.34 and 1.88 times more likely to have less life satisfaction and have unsatisfactory MCS scores. Being male was associated with protective odds (0.7) for reporting less pain.

Conclusions: Females have less favorable outcomes 2 weeks after TBI. The development of sex-based intervention strategies may optimize outcomes after TBI.