Traumatic brain injury mechanism of injury in adults: analysis by injury severity and sex in the National Trauma Databank.

Abstract

Background: Traumatic brain injuries (TBIs) are a global health issue, causing significant morbidity, mortality, and healthcare costs. Despite their prevalence, research gaps remain, particularly regarding adults aged 18-64, sex disparities, mechanisms of injury (MOI), and moderate TBI severity.

Methods: This cross-sectional study analyzed data from the National Trauma Data Bank (NTDB), comprising 747 trauma-designated hospitals (N = 299,856). The study examined sociodemographic characteristics associated with TBI severity overall and by sex, and tested for effect modification between TBI severity and MOI by sex. Multinomial logistic regression was used to assess associations between MOI and TBI severity, adjusting for covariates.

Results: Significant effect modification was found between TBI severity and MOI by sex. Transportation-related TBIs were the most common MOI across all severities and sexes, emphasizing the need for targeted prevention strategies. Disparities were identified, with fewer severe TBI cases treated at level I trauma centers and larger hospitals, indicating barriers to optimal care. Females exhibited higher TBI severity compared to males.

Conclusion: The study highlights the significant burden of transportation-related TBIs and sex disparities in injury outcomes, particularly the higher severity among females. These findings call for sex-specific prevention strategies and further research into post-injury outcomes and healthcare access for severe TBI cases.