Abstract
Objective
To determine sex differences in the recovery and prognosis after mild traumatic brain
injury (MTBI) in adults and children.
Data Sources
We analyzed all scientifically admissible primary studies in the World Health Organization
(WHO) (n=120) and International Collaboration on Mild Traumatic Brain Injury Prognosis
(ICoMP) (n=101) systematic reviews regarding prognosis of MTBI for sex-stratified
findings. They searched MEDLINE and other databases from 1980 through 2000 (WHO) and
2001 through 2012 (ICoMP) for published, peer-reviewed reports in English and other
languages.
Study Selection
We selected controlled trials and cohort and case-control studies that assessed the
effect of sex on outcomes after MTBI.
Data Extraction
Data from the eligible studies from both systematic reviews combined (n=14, 7%) were
extracted into evidence tables.
Data Synthesis
Prognostic information relating to sex was prioritized according to design as exploratory
or confirmatory, and a best-evidence synthesis was conducted. After MTBI, females
may have a higher risk of epilepsy (children, young adults) and suicide, and use more
health care services; males may be at higher risk for schizophrenia. Most studies
did not find a sex difference for postconcussion symptoms in children and adults.
No sex difference was found for risk of dementia and primary brain tumor, return to
work, or posttraumatic stress syndrome.
Conclusions
Sex is not a well-studied prognostic indicator for recovery after MTBI, but small
sex differences were found for some outcomes. More well-designed studies are needed
that report outcomes according to sex and control for potential confounders.
Keywords
List of abbreviations:
CI (confidence interval), ED (emergency department), ICoMP (International Collaboration on Mild Traumatic Brain Injury Prognosis), MTBI (mild traumatic brain injury), OR (odds ratio), PCS (postconcussion symptoms), PTSD (posttraumatic stress disorder), RPQ (Rivermead Postconcussion Symptoms Questionnaire), RR (relative risk), RTW (return to work), TBI (traumatic brain injury), WHO (World Health Organization)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: February 06, 2015
Footnotes
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
