Neurotrauma reports最新文献

{"title":"The Impact of Time from Diagnosis to Operating Room on Functional Outcomes in Patients with Traumatic Brain Injury: A Retrospective Study.","authors":"Cheewin Khawprapa, Sasithorn Khawprapa","doi":"10.1177/08977151251366985","DOIUrl":"10.1177/08977151251366985","url":null,"abstract":"<p><p>This study compares the functional outcomes of post-traumatic neurosurgical patients who underwent surgery within 4 h of diagnosis with those who underwent surgery >4 h after diagnosis. A retrospective analysis was conducted on patients who underwent traumatic neurosurgery at Sakon Nakhon Hospital between 2018 and 2024. The study included 164 patients, divided into two groups of 82 patients each. Group 1 underwent surgery within 4 h of diagnosis, while Group 2 underwent surgery after 4 h. The Glasgow Outcome Scale-Extended scores at 3 months post-operatively were significantly more favorable in Group 1 compared with Group 2 (<i>p</i> = 0.011). Additionally, the Barthel Index at 1 month and 3 months post-operatively was significantly higher in Group 1 (<i>p</i> = 0.044, 0.007, respectively). The findings suggest that early surgical intervention within 4 h of diagnosis leads to better functional outcomes in patients with traumatic brain injury.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"681-685"},"PeriodicalIF":1.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Features of Electroencephalography Associated with Improved Awareness in Persistent Vegetative State via Multiscale Entropy: A Machine Learning Modeling Study.","authors":"Keyun Lai, Xiao Chen, Liyun He, Qi Liu, Changsheng Lai, Yang Bai, Ye Zhang, Kaiyue Wang, Fangzhao Wang, Shuai He, Guangjun Wang","doi":"10.1177/2689288X251369274","DOIUrl":"10.1177/2689288X251369274","url":null,"abstract":"<p><p>Accurate differentiation between persistent vegetative state (PVS) and minimally conscious state and estimation of recovery likelihood in patients in PVS are crucial. This study analyzed electroencephalography (EEG) metrics to investigate their relationship with consciousness improvements in patients in PVS and developed a machine learning prediction model. We retrospectively evaluated 19 patients in PVS, categorizing them into two groups: those with improved consciousness (<i>n</i> = 7) and those without improvement (<i>n</i> = 12). Spectral and complexity analyses were performed on patients' EEG data to obtain spectral power and multiscale entropy (MSE) values. These metrics served as features in developing an EEG-based prediction model for consciousness improvement. Spectral power and MSE values were used as features in six machine learning models-support vector machine (SVM), Classification and Regression Tree, chi-squared automatic interaction detector, neural network, C5.0, and logistic regression-to perform classification via data mining methods. The dataset, containing data of 19 cases, was divided into training and test sets at a 50% ratio. The SVM model using MSE features yielded the best classification results, with prediction accuracies of 95.18% (training set) and 92.93% (test set). The logistic regression model achieved 93.25% and 84.51% accuracy, respectively. In the test set, the MSE-based SVM model demonstrated a 27.67% improvement in classification accuracy compared with models using spectral analysis features, indicating that MSE achieves better classification performance. This study demonstrates that MSE is a promising predictor of prognosis in patients in EEG-confirmed vegetative states.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"720-731"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coupling of Event-Related Potential and Pupil Dilation as a Compensatory Marker of Executive Attention in Traumatic Brain Injury.","authors":"Giacomo Scanavini, Isabelle Martin, Ludvik Alkhoury, Ana Radanovic, Yakira Tepler, Abhishek Jaywant, N Jeremy Hill, Tracy Butler, Keith W Jamison, Amy Kuceyeski, Nicholas D Schiff, Sudhin A Shah","doi":"10.1177/2689288X251370997","DOIUrl":"10.1177/2689288X251370997","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) impairs attention and executive function, often through disrupted coordination between cognitive and autonomic systems. While electroencephalography (EEG) and pupillometry are widely used to assess neural and autonomic responses independently, little is known about how these systems interact in TBI. Understanding their coordination is essential to identify compensatory mechanisms that may support attention under conditions of neural inefficiency. In this study, we examined pupil dilation during the Attention Network Test in individuals with TBI (<i>n</i> = 25) and controls without brain injury (<i>n</i> = 45). TBI participants exhibited preserved accuracy but slower reaction times (RTs), suggesting increased cognitive effort. Paradoxically, this effort was not reflected in heightened pupil dilation. Instead, pupil responses were attenuated, suggesting impaired recruitment of the locus coeruleus-norepinephrine system and possible autonomic dysregulation. We further assessed the relationship between simultaneously recorded pupillary responses and visual evoked responses in a subset of those in whom both measures were available (<i>n</i> = 23, TBI; <i>n</i> = 35, controls). Crucially, while both pupil dilation and amplitude of the visual P3 event-related potential were reduced in TBI, these measures showed a positive correlation across participants with TBI; this was absent in controls. Our results suggest that TBI may induce a compensatory coupling between cortical and autonomic systems to sustain cognitive performance despite underlying dysfunction. Positive correlation between pupil dilation and event-related potential suggest a role for arousal dysregulation in subjects with TBI. Our findings provide new evidence for altered EEG-pupil dynamics in TBI and highlight the potential of combining cortical and autonomic measures as a multimodal biomarker for tracking recovery, stratifying injury severity, and guiding individualized rehabilitation strategies.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"706-719"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of Injury Biomarkers in Sweat of Collegiate Athletes Pre- and Post-Football Season: A Pilot Study.","authors":"Sarah E Svirsky, Christopher C Wood, Olivia Raymond, Peyton McIntyre, Hannah Appleton, Chelsea Wagner, Jessica Gill, Ava M Puccio","doi":"10.1177/08977151251367345","DOIUrl":"10.1177/08977151251367345","url":null,"abstract":"<p><p>The sports medicine community and society at large have recognized traumatic brain injury (TBI) as a major public health concern. It is estimated that more than 150 million youths have played football in the United States. As an alternative to blood, sweat is a potential source for protein biomarkers, providing a non-invasive method for objective measurements for head safety guidelines. This pilot study explores sweat as a means of detecting protein biomarkers of brain injury before and after a football season. Participants were football players from an NCAA Division III college (<i>N</i> = 34 pre-season, <i>N</i> = 18 post-season). At pre- and post-season time points, demographic, injury history, and physical activity assessments were conducted, including application of a non-invasive sweat patch for approximately 24 h. Sweat protein biomarkers total-tau, neurofilament light, glial fibrillary acidic protein, and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) were measured via immunoarray. Paired and un-paired non-parametric statistical analyses were conducted. Athletes reported little to no concussion injuries from the season and experienced minimal symptoms. There was a significant increase in pre-season GFAP and UCH-L1 protein levels in athletes with a history of TBI compared to those without. Comparing between pre- and post-season, there was an increase in total-tau and UCH-L1 levels. These data suggest that sweat may be a viable biofluid to assess head injury using hallmark TBI biomarkers.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"700-705"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Management Strategies and Adverse Effects of Opioids in Patients with Neurotrauma with Acute and Chronic Pain.","authors":"Marie-Ève McGennis, Marc-Aurèle Gagnon, Jérôme Paquet, Alexis F Turgeon, Tassia Macedo, Caroline Côté, Mwanack Kakule Matina, Michael Verret, Lynne Moore, Andréane Richard-Denis, Line Guénette, Léonie Archambault, Cécile Duval, Mélanie Bérubé","doi":"10.1177/08977151251365585","DOIUrl":"10.1177/08977151251365585","url":null,"abstract":"<p><p>Pain is prevalent and a major source of disability after a traumatic brain injury (TBI) and a spinal cord injury (SCI). With a view of reducing the pain burden in neurotrauma, this study aimed to describe the use of pain management strategies and the adverse effects of opioids in patients with TBI and SCI. We collected data at hospital discharge (T1) and at 3 months post-injury (T2). A total of 70 patients, including 49 with TBI and 21 with SCI, with a mean age of 56 years (±21.1, ±17.9) were included. Almost a third of participants with TBI (33%) and SCI (29%) had a moderate average pain intensity at T1, and most experienced mild average pain intensity at T2. At T1, 80% of participants used opioids, whereas at T2, 26% of participants with TBI and 53% of those with SCI did. The main co-analgesic used was acetaminophen, with 78% and 17% for participants with TBI and 81% and 40% for participants with SCI at T1 and T2. The most common non-pharmacological strategy in participants with TBI was rest at T1 (45%) and T2 (32%), and comfortable positioning in participants with SCI at both timepoints (81% and 53%). The two most frequent adverse effects of opioids in both populations at T1 and T2 were drowsiness (35% vs. 43%; 10% vs. 13%) and constipation (27% vs. 38%; 7% vs. 20%). Opioids remain the most widely used pain management strategy in neurotrauma. Promoting a judicious use of opioids, combined with other strategies, could help patients with neurotrauma achieve adequate and safe pain relief.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"686-699"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding How Mild Traumatic Brain Injury Impacts the Career and Independence of Young Adults.","authors":"Juliet Haarbauer-Krupa, Jason Barber, Nancy Temkin, Lindsay D Nelson, Tracey Wallace, Nathan Barnett","doi":"10.1177/08977151251362109","DOIUrl":"10.1177/08977151251362109","url":null,"abstract":"<p><p>Research on mild traumatic brain injury (mTBI) and its impact on young adults is limited, despite this being an important time in their lives to work toward independence and career development. We analyzed data on 663 persons aged 17-29 years old with mTBI (i.e., TBI with Glasgow Coma Scale scores 13-15) and 170 controls who did not experience an injury from the multicenter, Transforming Research and Clinical Knowledge in TBI study. We assessed participants with mTBI, subdivided into those with computed tomography (CT) evidence of TBI (CT+) and those without (CT-), at 12 months post-injury with measures to examine symptom persistence, work and school status, and functional outcomes. Results indicated differences between mTBI and control participants related to return-to-work, return-to-school, and persistent symptoms. Those in the mTBI group were more likely to experience adverse symptoms and detrimental functional effects compared with controls at 12-months post-injury. However, other factors that may not have been measured could have contributed to these outcomes. Young adults are in a transition period where they are working to achieve independence and to establish careers; however, if they sustain a TBI, they, their families, and their medical providers may not understand how the injury contributes to their outcomes, and they may also have limited experience in seeking resources for care. Outcomes for mTBI could also disrupt their career and life trajectories, making this an important area for further investigation and intervention.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"651-659"},"PeriodicalIF":1.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gap Expansion Between Cranial Bone and Polyether Ether Ketone Implant in Cranioplasty of Pediatric Patients after Decompressive Craniectomy at Follow-up.","authors":"Chuanwei Wang, Chen Yang, Runlu Zhang, Yuan Zhang, Yanzhao Wang, Liping Ning, Guoran Du, Zhaoxi Sang, Shilei Ni, Xingang Li, Jie Gong","doi":"10.1089/neur.2025.0007","DOIUrl":"10.1089/neur.2025.0007","url":null,"abstract":"<p><p>This study aimed to explore the experience and complications of cranioplasty (CP) with polyether ether ketone (PEEK) in pediatric and adolescent patients after decompressive craniectomy (DC). A total of 62 children (aged <18 years) with cranial bone defects due to DC underwent CP with a custom-made PEEK at our department between January 2018 and April 2023. The clinical characteristics, radiological features, surgical conditions, postoperative complications, and follow-up results of these patients were analyzed retrospectively. Kaplan-Meier survival analysis and Cox regression were used to analyze data. The age of the patients ranged from 2 to 17 years. The follow-up periods ranged from 12 to 70 months. Six patients experienced subcutaneous fluid accumulation (9.7%), five experienced epidural fluid accumulation (8.1%), and two experienced scalp inflammation (3.2%), which all were cured before discharge. Seven patients experienced bone gap expansion at the interface between the cranial bone and PEEK during follow-up (11.3%). Univariate analysis showed that DC-CP time interval (<3 months) and age were two influencing factors. Multivariate analysis revealed that age was the most important factor (<i>p</i> < 0.005, hazard ratio = 0.250, 95% confidence interval: 0.096-0.652). No reoperation was performed. Medical follow-ups were carried out further. For pediatric patients with cranial defects after DC who receive CP with a custom-made PEEK, two variables including younger age and too short DC-CP time interval may be unfavorable factors, to make patients experience bone gap expansion at the interface between the cranial bone and the PEEK. Additional data should be collected to validate our conclusions.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"660-668"},"PeriodicalIF":1.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Lifetime Exposure to Sports-Related Head Impacts on Brain Injury and Inflammatory Blood Biomarkers Among Former Middle-Aged Athletes.","authors":"Grace O Recht, Giselle Lima-Cooper, Claire V Buddenbaum, Sage H Sweeney, Zachary S Bellini, Sharlene D Newman, Dibyadyuti Datta, Keisuke Kawata","doi":"10.1177/08977151251362101","DOIUrl":"10.1177/08977151251362101","url":null,"abstract":"<p><p>Repetitive head impacts from contact sports are associated with an increased risk of neurodegenerative conditions. While studies have examined acute and chronic outcomes in young and deceased athletes, research on middle-aged former athletes remains limited. We employed multiplex biomarker approaches to examine whether brain injury and systemic inflammatory blood biomarkers are reflective of ≥10 years of participation in contact sports in retired, middle-aged amateur athletes. This cross-sectional study included a cohort of 41 former contact athletes (32 male, 9 female) and 22 age- and sex-matched noncontact athletes (14 male, 8 female). Blood biomarkers of brain injury, including glial fibrillary acidic protein, ubiquitin C-terminal hydrolase L1 (UCH-L1), tau, and neurofilament light (NfL), alongside 18 systemic inflammatory markers, were examined via linear regression models with age and concussion history as covariates. Our analyses revealed no significant differences in brain injury blood biomarkers between groups. However, increasing age was associated with increased NfL levels in contact athletes, while greater concussion history correlated with elevated UCH-L1 and tau in contact athletes only. Contact athletes exhibited significantly increased levels of systemic inflammatory markers, including IL-8, CCL-2, CCL-3, IL-2, VCAM-1, and S100B. While brain injury blood biomarkers did not differ between groups, the association between age, concussion history, and increased NfL, UCH-L1, and tau levels in the contact group suggests potential long-term neural consequences of repetitive head impacts. Elevated systemic inflammatory markers potentially highlight a chronic inflammatory response in former contact athletes, underscoring the need for continued monitoring and interventions to mitigate neurodegenerative risk.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"638-650"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ante-Mortem Clinical Characterization with Post-Mortem Family Interview and Medical Record Abstraction in a Traumatic Brain Injury Brain Donor Program.","authors":"Amelia J Hicks, Enna Selmanovic, Ariel Pruyser, Carley R Trentman, Joshua C Klein, Kaitlyn Wilkey, Miguel X Escalon, Natalia Bernal-Fernández, Belinda Yew, Kristen Dams-O'Connor","doi":"10.1177/08977151251362180","DOIUrl":"10.1177/08977151251362180","url":null,"abstract":"<p><p>Recent investments in large-scale mortem tissue collection have accelerated opportunities to understand the neuropathology of traumatic brain injury (TBI) and post-traumatic neurodegeneration (PTND). Clinicopathological correlation requires ante-mortem clinical information. Post-mortem family interviews (PFIs) are an established method to capture comprehensive ante-mortem clinical information. The aim of this report was to summarize our experience of using the PFI in the Late Effects of TBI (LETBI) brain donor program to facilitate replication, expansion, and refinement of PFI methods in TBI brain donor programs. We describe the content development and structure of the LETBI PFI; interviewer training and qualifications; and considerations regarding interview duration, informant selection, and interview timing, as well as PFI inter-rater reliability. We also compare the information captured in the PFI with data abstracted from the medical records for 34 decedents in the LETBI brain donor program to illustrate the complementarity of these approaches and highlight the unique contributions of the PFI. The PFI can provide granular details about a decedent's clinical history and symptom trajectories over time, potential contributing factors to PTND including social determinants of health (e.g., race and years of education), family history of medical and psychiatric conditions, and contextual information regarding cause(s) of death. The PFI is an important component of a multi-modal autopsy that provides unique insights essential for clinical-pathological correlation investigations of chronic TBI and PTND neuropathology.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"624-637"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Mortality Among Adult Females Diagnosed with Traumatic Brain Injury in an Academic Medical System.","authors":"Bernadette A D'Alonzo, Abigail C Bretzin, Rebecca B Morse, Silvia P Canelón, Douglas J Wiebe, Andrea L C Schneider, Mary Regina Boland","doi":"10.1177/08977151251361700","DOIUrl":"10.1177/08977151251361700","url":null,"abstract":"<p><p>The objective of this retrospective cohort study was to evaluate mortality risk over five years among 6,432 female patients with a health care encounter diagnosis of TBI from hospitals and outpatient clinics within a university health system. We used TBI severity, defined by the Centers for Disease Control and Department of Defense/Veterans Affairs: mild, moderate/severe/penetrating, indeterminate severity. To determine patient death, we used death in a Penn Medicine facility and linkage to the Social Security Death Index. We used Cox proportional hazards models adjusted for age at the time of TBI diagnosis, race, and encounter type to estimate associations of TBI severity with mortality risk. We evaluated interactions with encounter type and age, and stratified results by inpatient/outpatient and age group (≥65 years). Median age was 47 years (25th-75th percentiles: 29-63). Patients were most commonly self-reported White race (<i>n</i> = 4,126, 64.0%), and diagnosed at an outpatient encounter (<i>n</i> = 5,099, 79.3%; among them, 1-2% urgent/emergent). Median follow-up time was 4.22 years (IQR, 2.3-4.9 years). Overall, 2.9% (<i>n</i> = 185) of patients died within five years of injury. Compared with mild TBI, mortality risk over five years was 2.06 times higher (95% CI = 1.27-3.33) for moderate/severe/penetrating TBI, and 1.54 times higher (95% CI = 0.98-2.42) for indeterminate TBI. Associations were attenuated among females with inpatient encounter type and those aged 65 years or older. Our results demonstrate that TBI severity affects survival among females, and this differs by encounter type and age. Findings motivate future, more focused research into the dynamics of TBI among females.</p>","PeriodicalId":74300,"journal":{"name":"Neurotrauma reports","volume":"6 1","pages":"613-623"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12419401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}