Citation

Cancelliere C, Donovan J, Cassidy JD. Arch. Phys. Med. Rehabil. 2015; 97(2 Suppl): S5-S18.

Affiliation

Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada; Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.11.028

PMID

25666784

Abstract

OBJECTIVE: To determine sex differences in the recovery and prognosis after MTBI in adults and children. DATA SOURCES: We analyzed all scientifically admissible primary studies in the World Health Organization (WHO) (n=120) and International Collaboration on Mild Traumatic Brain Injury Prognosis (ICoMP) (n=101) systematic reviews regarding prognosis of MTBI for sex-stratified findings. They searched MEDLINE and other databases from 1980-2000 (WHO) and 2001-2012 (ICoMP) for published, peer-reviewed reports in English and other languages. STUDY SELECTION: We selected controlled trials, cohort and case-control studies that assessed the effect of sex on outcomes following MTBI. DATA EXTRACTION: Data from the eligible studies from both systematic reviews combined (n=14, 7%) were extracted into evidence tables. DATA SYNTHESIS: Prognostic information relating to sex was prioritized according to design as exploratory or confirmatory and a best-evidence synthesis was conducted. After MTBI, females may have a higher risk of epilepsy (children, young adults) and suicide, and use more healthcare services; males may be at higher risk for schizophrenia. The majority of studies did not find a sex difference for post-concussion symptoms in children and adults. No sex difference was found for risk of dementia and primary brain tumour, return-to-work, or post-traumatic stress syndrome.

CONCLUSIONS: Sex is not a well-studied prognostic indicator for recovery after MTBI, but small sex differences were found for some outcomes. More well-designed studies are needed that report outcomes according to sex and control for potential confounders.

Language: en