Sex-specific impacts of obesity on long-term prognosis of traumatic brain injury: a multicenter prospective study

Abstract

Our investigation delves into the nuanced interplay between obesity and sex on the long-term outcomes of traumatic brain injury (TBI), a relationship that previous studies have hinted at but not thoroughly elucidated. Acknowledging the divergent recovery paths of males and females post-TBI, we aimed to elucidate whether obesity’s prognostic impact on TBI prognosis is indeed sex-dependent. This study was a prospective multi-center cohort study conducted on adult TBI patients, with intracranial hemorrhage or diffuse axonal injury confirmed by radiological examination, admitted to five participating emergency departments (EDs) from December 2018 to March 2023. The study outcomes were 6-month disability and mortality. The primary exposure was obesity, defined as body mass index (BMI) over 25. Multi-level logistic regression analysis was performed to estimate the association between obesity and the study outcomes. We conducted a stratified analysis by sex to investigate whether the association between obesity and TBI outcomes differs between sex. Our multilevel logistic regression analysis, using the normal weight group as a reference, indicated that higher BMI categories over 25 did not significantly alter the risk of 6-month disability or mortality when compared to the normal weight group. Our study revealed a higher one-month disability rate in female TBI patients with a BMI over 30 compared to those with a normal BMI, highlighting the need for gender-specific approaches in managing and rehabilitating TBI outcomes.

Keywords

• sex
• obesity
• tbi