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Invited Critique |

Sex Differences for Traumatic Brain Injury Outcomes:  Comment on “Protection From Traumatic Brain Injury in Hormonally Active Women vs Men of a Similar Age”

Marie Crandall, MD
Arch Surg. 2011;146(4):442-443. doi:10.1001/archsurg.2011.34.
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Yeung et al have reported the results of a multicenter, retrospective cohort study of TBI outcomes between males and females. The authors analyzed 2 separate data sets (from Australia and Hong Kong) and found no sex differences in mortality. However, females in the Hong Kong cohort were found to have a higher risk of brain edema than males.

The stimulus for this study was likely the unresolved question of the effect of sex hormones on injury outcomes. In experimental models, progesterone administration has been linked to better TBI outcomes.14 However, clinical research has generated conflicting results. In several retrospective clinical studies ranging from 1800 to 72 000 patients, results varied widely, from either men or women having a mortality advantage to no differences found.58

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