TY - JOUR
T1 - Age and sex-mediated differences in six-month outcomes after mild traumatic brain injury in young adults
T2 - a TRACK-TBI study
AU - the TRACK-TBI Investigators
AU - Yue, John K.
AU - Levin, Harvey S.
AU - Suen, Catherine G.
AU - Morrissey, Molly Rose
AU - Runyon, Sarah J.
AU - Winkler, Ethan A.
AU - Puffer, Ross C.
AU - Deng, Hansen
AU - Robinson, Caitlin K.
AU - Rick, Jonathan W.
AU - Phelps, Ryan R.L.
AU - Sharma, Sourabh
AU - Taylor, Sabrina R.
AU - Vassar, Mary J.
AU - Cnossen, Maryse C.
AU - Lingsma, Hester F.
AU - Gardner, Raquel C.
AU - Temkin, Nancy R.
AU - Barber, Jason
AU - Dikmen, Sureyya S.
AU - Yuh, Esther L.
AU - Mukherjee, Pratik
AU - Stein, Murray B.
AU - Cage, Tene A.
AU - Valadka, Alex B.
AU - Okonkwo, David O.
AU - Manley, Geoffrey T.
N1 - Publisher Copyright:
© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2019/7/3
Y1 - 2019/7/3
N2 - 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.
AB - 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.
KW - Age factors
KW - common data elements
KW - functional disability
KW - mild traumatic brain injury (mTBI)
KW - post-traumatic stress disorder (PTSD)
KW - risk factors
KW - sex
KW - young adults
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U2 - 10.1080/01616412.2019.1602312
DO - 10.1080/01616412.2019.1602312
M3 - Article
C2 - 31007155
AN - SCOPUS:85064671731
SN - 0161-6412
VL - 41
SP - 609
EP - 623
JO - Neurological Research
JF - Neurological Research
IS - 7
ER -