Gender and age effects on outcome after pediatric traumatic brain injury*

OBJECTIVE: To evaluate whether girls have better outcomes after traumatic brain injury than boys. DESIGN: Retrospective cohort study. SETTING: University hospital. PATIENTS: A 16,586 patient subset of the National Pediatric Trauma Registry with nonpenetrating traumatic brain injury. INTERVENTIONS: Retrospective review. MEASUREMENTS AND MAIN RESULTS: The patients were subdivided by age into prepubertal (0-7 yrs), indeterminate pubertal (8-12 yrs), and probable pubertal (13-19 yrs). All analyses were adjusted for injury severity using the Injury Severity Score. Outcome variables were in-hospital death rate, intensive care unit length of stay, total length of stay, discharge to home vs. rehabilitation, and functional status at discharge. Overall, 6.1% of girls and 5.3% of boys died. A higher proportion of girls were injured in motor vehicle crashes. Gender did not have a significant effect on in-hospital mortality rate after adjustment for age, Injury Severity Score, and motor vehicle crashes. Boys had a shorter intensive care unit length of stay (p =.027). There were no statistically significant differences between boys and girls in total hospital length of stay, functional outcome, and discharge location, although for every outcome there was a trend toward girls doing worse. CONCLUSIONS: There is evidence from this large study that girls do not have a better outcome after pediatric traumatic brain injury than boys, with a suggestion that girls may do worse.