Mortality Rates post-Traumatic Brain Injury Based on Gender

Background and/or Objectives: Research regarding the effects of gender on recovery of Traumatic Brain Injury (TBI) have yielded mixed results. Breeding et al.(2023) found that men with Moderate to Severe TBI have a lower in-hospital mortality risk when compared to females, but noted the need for more investigation. This study attempts to replicate Breeding et al.(2023) using the TrinetX database and further adds three methodological distinctions: propensity score matching to minimize confounding variables, disaggregating TBI severity, and investigate a time frame from 7-180 days to assess differences in temporal issues.

Design: Retrospective analysis of TrinetX database. We categorized male and female patients into three cohorts using the Glasgow coma scale (GCW): Moderate to Severe TBI (3-12), Moderate TBI (3-8), and Severe TBI 9-12). We compared groups at 7 days, 30 days, and 180 days post-TBI. Propensity score matching was conducted to cohort match.

Setting : Online

Participants : De-identified patients

Interventions: None

Main Outcome Measures: Mortality

Results: At 7 days post-TBI, Moderate to Severe patients have a mortality risk of 25.68% for males and 24.84% for females. Moderate patients have 8.09% for males and 7.30% for females. Severe patients have 32.96% for males and 33.07% for females. At 30 days, Moderate to Severe have a mortality risk of 33.55% for males and 31.76% for females. Moderate have 13.72% for males and 11.77% for females. Severe have 40.86% for males and 40.45% for females. At 180 days, Moderate to Severe have a mortality risk of 36.69% for males and 35.07% for females. Moderate showed 18.07% for males and 16.19% for females. Severe showed 42.4% for males and 42.13% for males. All groups showed no statistical difference.

Conclusions: This study indicated no statistical significance of post-TBI mortality risk between genders, regardless of TBI severity or time-frame. These results were surprising in light of Bredda et al.(2023), but not unexpected as research regarding this topic has been mixed.