Article (Scientific journals)
Explaining Outcome Differences between Men and Women following Mild Traumatic Brain Injury.
Mikolic, Ana; Groeniger, Joost Oude; Zeldovich, Marina et al.
2021In Journal of Neurotrauma, 38 (23), p. 3315-3331
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Keywords :
care pathways; mediation; outcomes; sex differences; sociodemographic factors; traumatic brain injury
Abstract :
[en] Men and women differ in outcomes following mild traumatic brain injury (TBI). In the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we previously found that women had worse 6-month functional outcome (Glasgow Outcome Score Extended [GOSE]), health-related quality of life (HRQoL), and mental health following mild TBI. The aim of this study was to investigate whether those differences were mediated by psychiatric history, gender-related sociodemographic variables, or by care pathways. We analyzed sex/gender differences in 6-month GOSE, generic and TBI-specific HRQoL, and post-concussion and mental health symptoms using three sets of mediators: psychiatric history, sociodemographic variables (living alone, living with children, education and employment status/job category), and care-pathways (referral to study hospital and discharge destination after emergency department); while controlling for a substantial number of potential confounders (pre-injury health and injury-related characteristics). We included 1842 men and 1022 women (16+) with a Glasgow Coma Score 13-15, among whom 83% had GOSE available and about 60% other 6-month outcomes. We used natural effects models to decompose the total effect of sex/gender on the outcomes into indirect effects that passed through the specified mediators and the remaining direct effects. In our study population, women had worse outcomes and these were only partly explained by psychiatric history, and not considerably explained by sociodemographic variables nor by care pathways. Factors other than differences in specified variables seem to underlie observed differences between men and women in outcomes after mild TBI. Future studies should explore more aspects of gender roles and identity and biological factors underpinning sex and gender differences in TBI outcomes.
Disciplines :
Human health sciences: Multidisciplinary, general & others
Author, co-author :
Mikolic, Ana;  Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the
Groeniger, Joost Oude;  Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the  ; Department of Public Administration and Sociology, Erasmus University, Rotterdam,
Zeldovich, Marina;  Institute of Medical Psychology and Medical Sociology, Georg-August-University,
Wilson, Lindsay;  Division of Psychology, University of Stirling, Stirling, United Kingdom.
van Lennep, Jeanine Roeters;  Department of Internal Medicine, Erasmus MC-University Medical Center, Rotterdam,
van Klaveren, David;  Department of Public Administration and Sociology, Erasmus University, Rotterdam,  ; Predictive Analytics and Comparative Effectiveness Center, Institute for Clinical
Polinder, Suzanne;  Department of Public Health, Erasmus MC-University Medical Center, Rotterdam, the
Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury
Other collaborator :
Åkerlund, Cecilia
Amrein, Krisztina
Andreassen, Lasse
Anke, Audny
Antoni, Anna
Audibert, Gérard
Azouvi, Philippe
Azzolini, Maria Luisa
Bartels, Ronald
Barzó, Pál
Beauvais, Romuald
Beer, Ronny
Bellander, Bo-Michael
Belli, Antonio
Benali, Habib
Berardino, Maurizio
Beretta, Luigi
Blaabjerg, Morten
Bragge, Peter
Brazinova, Alexandra
Brinck, Vibeke
Brooker, Joanne
Brorsson, Camilla
Buki, Andras
Bullinger, Monika
Cabeleira, Manuel
Caccioppola, Alessio
Calappi, Emiliana
Calvi, Maria Rosa
Cameron, Peter
Lozano, Guillermo Carbayo
Carbonara, Marco
Castaño-León, Ana M
Cavallo, Simona
Chevallard, Giorgio
Chieregato, Arturo
Citerio, Giuseppe
Ceyisakar, Iris
Clusmann, Hans
Coburn, Mark
Coles, Jonathan
Cooper, Jamie D
Correia, Marta
Čović, Amra
Curry, Nicola
Czeiter, Endre
Czosnyka, Marek
Dahyot-Fizelier, Claire
Dark, Paul
Dawes, Helen
Keyser, Véronique De
Degos, Vincent
Corte, Francesco Della
Boogert, Hugo den
Depreitere, Bart
Đilvesi, Đula
Dixit, Abhishek
Donoghue, Emma
Dreier, Jens
Dulière, Guy-Loup
Ercole, Ari
Esser, Patrick
Ezer, Erzsébet
Fabricius, Martin
Feigin, Valery L
Foks, Kelly
Frisvold, Shirin
Furmanov, Alex
Gagliardo, Pablo
Galanaud, Damien
Gantner, Dashiell
Gao, Guoyi
George, Pradeep
GHUYSEN, Alexandre ;  Centre Hospitalier Universitaire de Liège - CHU > > Service des urgences
Giga, Lelde
Glocker, Ben
Golubovic, Jagoš
Gomez, Pedro A
Gratz, Johannes
Gravesteijn, Benjamin
Grossi, Francesca
Gruen, Russell L
Gupta, Deepak
Haagsma, Juanita A
Haitsma, Iain
Helbok, Raimund
Helseth, Eirik
Horton, Lindsay
Huijben, Jilske
Hutchinson, Peter J
Jacobs, Bram
Jankowski, Stefan
Jarrett, Mike
Jiang, Ji-Yao
Johnson, Faye
Jones, Kelly
Karan, Mladen
Kolias, Angelos G
Kompanje, Erwin
Kondziella, Daniel
Koraropoulos, Evgenios
Koskinen, Lars-Owe
Kovács, Noémi
Kowark, Ana
Lagares, Alfonso
Lanyon, Linda
LAUREYS, Steven  ;  Centre Hospitalier Universitaire de Liège - CHU > > Centre du Cerveau²
Lecky, Fiona
LEDOUX, Didier  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service des soins intensifs
Lefering, Rolf
Legrand, Valerie
Lejeune, Aurelie
Levi, Leon
Lightfoot, Roger
Lingsma, Hester
Maas, Andrew I R
Maegele, Marc
Majdan, Marek
Manara, Alex
Manley, Geoffrey
Martino M, Costanza
Maréchal, Hugues
Mattern, Julia
McMahon, Catherine
Melegh, Béla
Menon, David
Menovsky, Tomas
Mikolic, Ana
Misset, Benoît ;  Centre Hospitalier Universitaire de Liège - CHU > > Service des soins intensifs
Muraleedharan, Visakh
Murray, Lynnette
Negru, Ancuta
Nelson, David
Newcombe, Virginia
Nieboer, Daan
Nyirádi, József
Olubukola, Otesile
Oresic, Matej
Ortolano, Fabrizio
Palotie, Aarno
Parizel, Paul M
Payen, Jean-François
Perera, Natascha
Perlbarg, Vincent
Paris, Hopitaux de
Persona, Paolo
Peul, Wilco
Pirinen, Matti
Ples, Horia
Polinder, Suzanne
Pomposo, Inigo
Posti, Jussi P
Puybasset, Louis
Radoi, Andreea
Ragauskas, Arminas
Rambadagalla, Malinka
Rhodes, Jonathan
Richardson, Sylvia
Richter, Sophie
Ripatti, Samuli
Rocka, Saulius
Roe, Cecilie
Roise, Olav
Rosand, Jonathan
Rosenlund, Christina
Rosenthal, Guy
Rossaint, Rolf
Rossi, Sandra
Rueckert, Daniel
Rusnák, Martin
Sahuquillo, Juan
Sakowitz, Oliver
Sanchez-Porras, Renan
Sandor, Janos
Schäfer, Nadine
Schmidt, Silke
Schoechl, Herbert
Schoonman, Guus
Schou, Rico Frederik
Schwendenwein, Elisabeth
Sewalt, Charlie
Skandsen, Toril
Smielewski, Peter
Sorinola, Abayomi
Stamatakis, Emmanuel
Stanworth, Simon
Stevens, Robert
Stewart, William
Steyerberg, Ewout W
Stocchetti, Nino
Sundström, Nina
Synnot, Anneliese
Takala, Riikka
Tamás, Viktória
Tamosuitis, Tomas
Taylor, Mark Steven
Ao, Braden Te
Tenovuo, Olli
Theadom, Alice
Thomas, Matt
Tibboel, Dick
Timmers, Marjolein
Tolias, Christos
Trapani, Tony
Tudora, Cristina Maria
Vajkoczy, Peter
Vallance, Shirley
Valeinis, Egils
Vámos, Zoltán
Jagt, Mathieu van der
Steen, Gregory Van der
Naalt, Joukje van der
van Dijck, Jeroen T J M
Essen, Thomas A van
Hecke, Wim Van
Heugten, Caroline van
Praag, Dominique Van
Vyvere, Thijs Vande
Wijk, Roel P J van
Vargiolu, Alessia
Vega, Emmanuel
Velt, Kimberley
Verheyden, Jan
Vespa, Paul M
Vik, Anne
Vilcinis, Rimantas
Volovici, Victor
Steinbüchel, Nicole von
Voormolen, Daphne
Vulekovic, Petar
Wang, Kevin K W
Wiegers, Eveline
Williams, Guy
Wilson, Lindsay
Winzeck, Stefan
Wolf, Stefan
Yang, Zhihui
Ylén, Peter
Younsi, Alexander
Zeiler, Frederick A
Zelinkova, Veronika
Ziverte, Agate
Zoerle, Tommaso
More authors (233 more) Less
Language :
English
Title :
Explaining Outcome Differences between Men and Women following Mild Traumatic Brain Injury.
Publication date :
December 2021
Journal title :
Journal of Neurotrauma
ISSN :
0897-7151
eISSN :
1557-9042
Volume :
38
Issue :
23
Pages :
3315-3331
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 25 March 2022

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