Hirnverletzung - leiden Frauen mehr?

Fachleute sind intuitiv oft der Ansicht, dass Frauen sich besser von den Folgen einer Hirmverletzung erholen. Neuere Studien zeigen aber, dass Frauen öfter an Hirnverletzungen sterben und sich, wenn sie überleben, auch schlechter davon erholen als Männer.

Eine Studie des Southern California Injury Prevention Research Center (Universität Kalifornien, UCLA) zeigt, dass Frauen 1.75 mal häufiger an einer Hirnverletzung sterben als Männer. Das Risiko, dass Frauen sich schlecht von einer Hirnverletzung erholen, ist 1.57 mal grösser als bei Männern.

Diese Resultate werden bestätigt durch eine Untersuchung des Department of Neurosurgery, University of Virginia. Danach erholen sich Frauen in 85% der Fälle schlechter von einer Hirnverletzung als Männer.

Die Abstracts (Zusammenfassungen) der beiden Studien finden Sie hier:

Neurosurg Focus. 2000 Jan 15;8(1):e5.

The independent effect of gender on outcomes following traumatic brain injury: a preliminary investigation.

Kraus JF, Peek-Asa C, McArthur D.

Southern California Injury Prevention Research Center, Department of Epidemiology, UCLA School of Public Health, Los Angeles, California, USA.

Although epidemiological studies of gender differences in outcome after brain injury are limited, studies in animals indicate higher fatality rates for females. Studies in which healthy human brain metabolism was investigated also suggest gender differences. In this paper the authors examine gender as an independent predictor of survival following brain injury. A prospective cohort of severely and moderately brain injured individuals was identified from two trauma centers over a period of 3.5 years. Patients enrolled in the cohort were followed for as long as 18 months postdischarge. The Glasgow Outcome Scale was used to measure long-term outcome. Overall, mortality was 1.28 times higher in females than males, with the greatest difference of 2.14 found in deaths postdischarge. Controlling for age, admission Glasgow Coma Score, penetrating as compared with blunt injury, and the presence of multiple trauma, females were 1.75 times more likely than males to die of their brain injury (95% confidence interval 1.09-2.82). Furthermore, females were 1.57 times more likely to experience poor outcomes (that is, severe disability or persistent vegetative state) than males. These findings suggest the need to examine similar effects in different cohorts and to identify the pathophysiological basis for the differences observed in this epidemiological study.

PMID: 16906701 [PubMed - in process]

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29: Neurosurg Focus. 2000;8(1):e6.

Do women fare worse? A metaanalysis of gender differences in outcome after traumatic brain injury.

Farace E, Alves WM.

Department of Neurosurgery, University of Virginia, Charlottesville, Virginia 22908, USA. farace@virginia.edu

The purpose of this metaanalysis was to investigate possible gender differences in TBI sequelae. The case fatality rates in patients after TBI have previously been shown to be significantly higher in women as compared with men. A quantitative review of published studies of TBI outcome revealed eight studies (20 outcome variables) of TBI in which outcome was reported separately for men and women. Outcome was worse in women than in men for 85% of the measured variables, with an average effect size of -0.15. Although clinical opinion is often that women tend to experience better outcomes than do men after TBI, the opposite pattern was suggested in the results of this metaanalysis. However, this conclusion is limited by the fact that in only a small percentage of the total published reports on TBI outcome was outcome described separately for each sex. A careful, prospective study of sex differences in TBI outcome is clearly needed.

PMID: 16924776 [PubMed - in process]

Die vollständigen Studien können Sie beispielsweise hier bestellen: www.medline.ch