Do women fare worse: a metaanalysis of gender differences in traumatic brain injury outcome

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Object. The purpose of this metaanalysis was to investigate possible gender differences in traumatic brain injury (TBI) sequelae. The case fatality rates in patients after TBI have previously been shown to be significantly higher in women as compared with men.

Methods. A quantitative review of published studies of TBI outcome revealed eight studies (20 outcome variables) of TBI, in which outcome was reported separately for men and women.

Conclusions. Outcome was worse in women than in men for 85% of the measured variables, with an average effect size of −0.15. Although clinical opinion is often that women tend to experience better outcomes than men after TBI, the opposite pattern was suggested in the results of this metaanalysis. However, this conclusion is limited by the fact that, in only a small percentage of the total published reports on TBI outcome, was outcome described separately for each sex. A careful, prospective study of sex differences in TBI outcome is clearly needed.

Article Information

Address reprint requests to: Elana Farace, Ph.D., Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia 22908. email: farace@virginia.edu.

© AANS, except where prohibited by US copyright law.

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Figures

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    Graph displaying effect sizes of TBI outcome measures for 20 outcome variables reported separately by gender. Shaded bars indicate a reported significant statistical difference by study. Bars extending to the right indicate variables for which men had worse outcome, and bars extending to the left indicate variables for which women had worse outcome.

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