Sex and age differences in isolated traumatic brain injury: a retrospective observational study.
Sex and age differences in isolated traumatic brain injury: a retrospective observational study.
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DOI：
10.1186/s12883-021-02305-6
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发表时间：
2021-07-05
期刊：
影响因子：
2.6
通讯作者：
Shimazu T
中科院分区：
文献类型：
--
作者：
Hosomi S;Kitamura T;Sobue T;Ogura H;Shimazu T
在许多可能影响创伤性脑损伤（TBI）进展的因素中，性是最具争议的因素之一。本研究的目的是利用日本最大的创伤登记处的数据，调查脑外伤相关发病率和死亡率的性别差异。这项基于人群的回顾性观察性研究纳入了2004年至2018年在全国数据库中登记的孤立性脑损伤患者。我们排除了颅外损伤（简略损伤量表评分≥3）的患者，并排除了潜在的混杂因素，如非神经系统原因的死亡。患者按年龄和死亡率分层，并比较男女伤后并发症。共纳入51,726例孤立性TBI患者（16,901例女性，34,825例男性）。所有年龄段男性和女性的死亡率分别为12.01%（2030/16901）和12.76%（4445/34825）。与女性相比，男性TBI死亡率的校正优势比（OR）为1.32（95%可信区间[CI]， 1.22-1.42）。10-19岁和≥60岁男性的死亡率明显高于同一年龄组的女性（10-19岁：校正OR， 1.97 [95% CI, 1.08-3.61]； 60 - 69岁：校正OR， 1.24 [95% CI, 1.02-1.50]； 70-79岁：校正OR， 1.20 [95% CI, 1.03-1.40]； 80-89岁：校正OR， 1.50 [95% CI, 1.31-1.73]； 90-99岁：校正OR， 1.72 [95% CI, 1.28-2.32]）。在tbi后神经系统和非神经系统并发症的发生率方面，男性与女性的粗or分别为1.29 （95% CI, 1.19-1.39）和1.14 （95% CI, 1.07-1.22）。这种差异在老年患者中尤为明显（神经系统并发症：OR， 1.27 [95% CI, 1.14-1.41]；非神经系统并发症：OR， 1.29 [95% CI, 1.19-1.39]）。在日本全国范围内的TBI患者样本中，男性的死亡率高于女性。这种差异在年轻一代和老一代之间尤为明显。此外，老年男性比同龄女性有更多的TBI并发症。在线版本包含补充材料，可在10.1186/s12883-021-02305-6获得。
Among the many factors that may influence traumatic brain injury (TBI) progression, sex is one of the most controversial. The objective of this study was to investigate sex differences in TBI-associated morbidity and mortality using data from the largest trauma registry in Japan. This retrospective, population-based observational study included patients with isolated TBI, who were registered in a nationwide database between 2004 and 2018. We excluded patients with extracranial injury (Abbreviated Injury Scale score ≥ 3) and removed potential confounding factors, such as non-neurological causes of mortality. Patients were stratified by age and mortality and post-injury complications were compared between males and females. A total of 51,726 patients with isolated TBI were included (16,901 females and 34,825 males). Mortality across all ages was documented in 12.01% (2030/16901) and 12.76% (4445/34825) of males and females, respectively. The adjusted odds ratio (OR) of TBI mortality for males compared to females was 1.32 (95% confidence interval [CI], 1.22–1.42]. Males aged 10–19 years and ≥ 60 years had a significantly higher mortality than females in the same age groups (10–19 years: adjusted OR, 1.97 [95% CI, 1.08–3.61]; 60–69 years: adjusted OR, 1.24 [95% CI, 1.02–1.50]; 70–79 years: adjusted OR, 1.20 [95% CI, 1.03–1.40]; 80–89 years: adjusted OR, 1.50 [95% CI, 1.31–1.73], and 90–99 years: adjusted OR, 1.72 [95% CI, 1.28–2.32]). In terms of the incidence of post-TBI neurologic and non-neurologic complications, the crude ORs were 1.29 (95% CI, 1.19–1.39) and 1.14 (95% CI, 1.07–1.22), respectively, for males versus females. This difference was especially evident among elderly patients (neurologic complications: OR, 1.27 [95% CI, 1.14–1.41]; non-neurologic complications: OR, 1.29 [95% CI, 1.19–1.39]). In a nationwide sample of patients with TBI in Japan, males had a higher mortality than females. This disparity was particularly evident among younger and older generations. Furthermore, elderly males experienced more TBI complications than females of the same age. The online version contains supplementary material available at 10.1186/s12883-021-02305-6.
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