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Age and sex-mediated differences in six-month outcomes after mild traumatic brain injury in young adults: a TRACK-TBI study.
Yue, John K; Levin, Harvey S; Suen, Catherine G; Morrissey, Molly Rose; Runyon, Sarah J; Winkler, Ethan A; Puffer, Ross C; Deng, Hansen; Robinson, Caitlin K; Rick, Jonathan W; Phelps, Ryan R L; Sharma, Sourabh; Taylor, Sabrina R; Vassar, Mary J; Cnossen, Maryse C; Lingsma, Hester F; Gardner, Raquel C; Temkin, Nancy R; Barber, Jason; Dikmen, Sureyya S; Yuh, Esther L; Mukherjee, Pratik; Stein, Murray B; Cage, Tene A; Valadka, Alex B; Okonkwo, David O; Manley, Geoffrey T.
Afiliación
  • Yue JK; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Levin HS; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Suen CG; c Departments of Neurology and Neurosurgery , Baylor College of Medicine , Houston , TX , USA.
  • Morrissey MR; d Department of Neurology , University of Utah , Salt Lake City , UT , USA.
  • Runyon SJ; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Winkler EA; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Puffer RC; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Deng H; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Robinson CK; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Rick JW; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Phelps RRL; e Department of Neurological Surgery , Mayo Clinic , Rochester , MN , USA.
  • Sharma S; f Department of Neurological Surgery , University of Pittsburgh Medical Center , Pittsburgh , PA , USA.
  • Taylor SR; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Vassar MJ; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Cnossen MC; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Lingsma HF; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Gardner RC; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Temkin NR; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Barber J; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Dikmen SS; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Yuh EL; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Mukherjee P; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Stein MB; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Cage TA; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Valadka AB; a Department of Neurological Surgery , University of California San Francisco , San Francisco , CA , USA.
  • Okonkwo DO; b Brain and Spinal Injury Center , Zuckerberg San Francisco General Hospital , San Francisco , CA , USA.
  • Manley GT; g Department of Public Health , Erasmus Medical Center , Rotterdam , The Netherlands.
Neurol Res ; 41(7): 609-623, 2019 Jul.
Article en En | MEDLINE | ID: mdl-31007155
ABSTRACT

Introduction:

Risk factors for young adults with mTBI are not well understood. Improved understanding of age and sex as risk factors for impaired six-month outcomes in young adults is needed.

Methods:

Young adult mTBI subjects aged 18-39 years (18-29y; 30-39y) with six-month outcomes were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study. Multivariable regressions were performed for outcomes with age, sex, and the interaction factor age-group*sex as variables of interest, controlling for demographic and injury variables. Mean-differences (B) and 95% CIs are reported.

Results:

One hundred mTBI subjects (18-29y, 70%; 30-39y, 30%; male, 71%; female, 29%) met inclusion criteria. On multivariable analysis, age-group*sex was associated with six-month post-traumatic stress disorder (PTSD; PTSD Checklist-Civilian version); compared with female 30-39y, female 18-29y (B= -19.55 [-26.54, -4.45]), male 18-29y (B= -19.70 [-30.07, -9.33]), and male 30-39y (B= -15.49 [-26.54, -4.45]) were associated with decreased PTSD symptomatology. Female sex was associated with decreased six-month functional outcome (Glasgow Outcome Scale-Extended (GOSE) B= -0.6 [1.0, -0.1]). Comparatively, 30-39y scored higher on six-month nonverbal processing speed (Wechsler Adult Intelligence Scale-Processing Speed Index (WAIS-PSI); B= 11.88, 95% CI [1.66, 22.09]).

Conclusions:

Following mTBI, young adults aged 18-29y and 30-39y may have different risks for impairment. Sex may interact with age for PTSD symptomatology, with females 30-39y at highest risk. These results may be attributable to cortical maturation, biological response, social modifiers, and/or differential self-report. Confirmation in larger samples is needed; however, prevention and rehabilitation/counseling strategies after mTBI should likely be tailored for age and sex.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conmoción Encefálica / Caracteres Sexuales Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Neurol Res Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conmoción Encefálica / Caracteres Sexuales Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Límite: Adolescent / Adult / Female / Humans / Male Idioma: En Revista: Neurol Res Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos