1. Age and sex-mediated differences in six-month outcomes after mild traumatic brain injury in young adults: a TRACK-TBI study.
- Author
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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 RL, 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, and TRACK-TBI Investigators
- Subjects
TRACK-TBI Investigators ,Humans ,Brain Concussion ,Glasgow Outcome Scale ,Prospective Studies ,Pilot Projects ,Stress Disorders ,Post-Traumatic ,Wechsler Scales ,Age Factors ,Sex Characteristics ,Adolescent ,Adult ,Female ,Male ,Young Adult ,Age factors ,common data elements ,functional disability ,mild traumatic brain injury ,post-traumatic stress disorder ,risk factors ,sex ,young adults ,Behavioral and Social Science ,Traumatic Head and Spine Injury ,Physical Injury - Accidents and Adverse Effects ,Brain Disorders ,Traumatic Brain Injury (TBI) ,Mental Health ,Post-Traumatic Stress Disorder (PTSD) ,Prevention ,Clinical Research ,Neurosciences ,2.3 Psychological ,social and economic factors ,Aetiology ,Mental health ,Clinical Sciences ,Neurology & Neurosurgery - 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.
- Published
- 2019