Traumatic brain injury (TBI) is a significant cause of disability, but little is known about sex and gender differences after TBI. We aimed to analyze the association between sex/gender, and the broad range of care pathways, treatment characteristics, and outcomes following mild and moderate/severe TBI. We performed mixed-effects regression analyses in the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, stratified for injury severity and age, and adjusted for baseline characteristics. Outcomes were various care pathway and treatment variables, and 6-month measures of functional outcome, health-related quality of life (HRQoL), post-concussion symptoms (PCS), and mental health symptoms. The study included 2862 adults (36% women) with mild (mTBI; Glasgow Coma Scale [GCS] score 13–15), and 1333 adults (26% women) with moderate/severe TBI (GCS score 3–12). Women were less likely to be admitted to the intensive care unit (ICU; odds ratios [OR] 0.6, 95% confidence interval [CI]: 0.4-0.8) following mTBI. Following moderate/severe TBI, women had a shorter median hospital stay (OR 0.7, 95% CI: 0.5-1.0). Following mTBI, women had poorer outcomes; lower Glasgow Outcome Scale Extended (GOSE; OR 1.4, 95% CI: 1.2-1.6), lower generic and disease-specific HRQoL, and more severe PCS, depression, and anxiety. Among them, women under age 45 and above age 65 years showed worse 6-month outcomes compared with men of the same age. Following moderate/severe TBI, there was no difference in GOSE (OR 0.9, 95% CI: 0.7-1.2), but women reported more severe PCS (OR 1.7, 95% CI: 1.1-2.6). Men and women differ in care pathways and outcomes following TBI. Women generally report worse 6-month outcomes, but the size of differences depend on TBI severity and age. Future studies should examine factors that explain these differences.

中文翻译：

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创伤性脑损伤后男性和女性在治疗和结果方面的差异。

创伤性脑损伤 (TBI) 是导致残疾的重要原因，但对 TBI 后的性别和性别差异知之甚少。我们旨在分析性别/性别与轻度和中度/重度 TBI 后广泛的护理途径、治疗特征和结果之间的关联。我们在创伤性脑损伤的前瞻性多中心协作欧洲神经创伤有效性研究 (CENTER-TBI) 研究中进行了混合效应回归分析，根据损伤严重程度和年龄进行分层，并根据基线特征进行调整。结果是各种护理途径和治疗变量，以及功能结果、健康相关生活质量 (HRQoL)、脑震荡后症状 (PCS) 和心理健康症状的 6 个月测量值。该研究包括 2862 名患有轻度 (mTBI; 格拉斯哥昏迷量表 [GCS] 评分 13-15），1333 名成人（26% 女性）患有中度/重度 TBI（GCS 评分 3-12）。mTBI 后，女性入住重症监护病房的可能性较小（ICU；优势比 [OR] 0.6，95% 置信区间 [CI]：0.4-0.8）。中度/重度 TBI 后，女性的中位住院时间较短（OR 0.7，95% CI：0.5-1.0）。在 mTBI 之后，女性的结果较差；Glasgow Outcome Scale Extended (GOSE; OR 1.4, 95% CI: 1.2-1.6)、一般和疾病特异性 HRQoL 较低，以及更严重的 PCS、抑郁和焦虑。其中，45岁以下和65岁以上的女性与同龄男性相比，6个月的结局更差。中度/重度 TBI 后，GOSE 没有差异（OR 0.9，95% CI：0.7-1.2），但女性报告更严重的 PCS（OR 1.7，95% CI：1.1-2.6）。男性和女性在 TBI 后的护理途径和结果方面存在差异。女性通常报告更糟糕的 6 个月结果，但差异的大小取决于 TBI 的严重程度和年龄。未来的研究应该检查解释这些差异的因素。