title: Protection from traumatic brain injury in hormonally active women vs men of a similar age: a retrospective international study.
abstract: BACKGROUND
  It has been suggested that women with traumatic brain injury have more favorable outcomes than do men because of higher levels of circulating estrogen and progesterone that may reduce brain edema.
  
  
  OBJECTIVE
  To determine whether there is any association between sex and mortality in TBI patients and whether there is any association between sex and brain edema.
  
  
  METHODS
  Retrospective cohort study using data from 2001 to 2007 collected from a trauma registry in Hong Kong and the Victorian State Trauma Registry.
  
  
  METHODS
  Two regional trauma centers in Hong Kong and 2 adult major trauma centers and 1 pediatric trauma center in Victoria, Australia.
  
  
  METHODS
  Mortality and brain edema.
  
  
  METHODS
  Trauma patients with an Abbreviated Injury Scale score (head) of at least 3 who were aged 12 to 45 years were included. Patients with minor head injury and undisplaced closed skull fracture were excluded.
  
  
  RESULTS
  Both the Hong Kong and Victorian data showed no significant difference in sex-related mortality. Increased mortality was associated with decreased systolic blood pressure and Glasgow Coma Scale score and with increased New Injury Severity Score or Injury Severity Score. In Hong Kong, brain edema was associated with female sex (P = .02), and the odds of brain edema in females were greater than for males. However, this association was not found in Victorian patients.
  
  
  CONCLUSIONS
  This study found no significant association between sex and mortality in either Victoria or Hong Kong and does not support the concept that females have better outcomes after traumatic brain injury.
authors.affiliation: Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, and Trauma and Emergency Centre, Prince of Wales Hospital, Main Clinical Block and Trauma Centre, Shatin, New Territories, Hong Kong.
authors.forename: Janice H H
authors.initials: JH
authors.lastname: Yeung
authors.forename: Antonina A
authors.initials: AA
authors.lastname: Mikocka-Walus
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.forename: Wai S
authors.initials: WS
authors.lastname: Poon
authors.forename: Hiu F
authors.initials: HF
authors.lastname: Ho
authors.forename: Annice
authors.initials: A
authors.lastname: Chang
authors.forename: Colin A
authors.initials: CA
authors.lastname: Graham
authors.forename: Timothy H
authors.initials: TH
authors.lastname: Rainer
mesh_terms: D000293:Adolescent; D000328:Adult; D001929:Brain Edema / Q000097:blood / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control*; D001930:Brain Injuries / Q000097:blood / Q000150:complications* / Q000401:mortality*; D015331:Cohort Studies; D004967:Estrogens / Q000097:blood*; D005260:Female; D005298:Fertility; D023261:Glasgow Outcome Scale; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D016017:Odds Ratio; D011374:Progesterone / Q000097:blood*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014739:Victoria / Q000453:epidemiology
chemical_list: D004967:Estrogens; D011374:Progesterone