4.4 Article

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

Journal

BRAIN INJURY
Volume 29, Issue 12, Pages 1439-1444

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.3109/02699052.2015.1071428

Keywords

Death; emergency care; gender; head injury; neurocritical care; outcome; traumatic brain injury

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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.

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