Effect of sex and age on traumatic brain injury: a geographical comparative study

Biswas, Raaj Kishore and Kabir, Enamul and King, Rachel (2017) Effect of sex and age on traumatic brain injury: a geographical comparative study. Archives of Public Health, 75 (1). ISSN 0778-7367

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Abstract

Background: Traumatic brain injury (TBI) is a much researched topic in medical health, which requires additionalstudies to understand various effects of demographic and geographic factors that can assist in developing the mosteffective treatments. Thousands of people of different ages are suffering from lifelong disabilities, either mild orsevere, from TBI and the number is increasing. This study aims to increase our understanding of the effect of sex andage by applying five different statistical methods to evaluate the effect of these covariates on two independent TBIdata sets representing patients from different geographical cohorts. A primary data was collected from Bangladeshand it was compared with CRASH (Corticosteroid Randomisation after Significant Head Injury) data, representingvarious countries around the world.

Methods: The outcome variable for TBI considered in this paper is Glasgow Outcome Scale, which is a four pointscale. It was converted to a binary outcome scale for fitting of Fisher’s exact test, a test of proportions and a binarylinear model. For analyzing ordinal outcomes, the proportional odds model and the sliding dichotomy model werefitted. As the sample size of the Bangladeshi data set was small, parametric bootstrapping was applied for theconsistency of results.

Results: Females were the worse sufferers of TBI compared to men, according to CRASH data set. The old (agedabove 58 years) followed by adults (age 25 to 58) were the most vulnerable victims. Interaction effects concluded thatold women tended to endure the worst outcomes of TBI. This conclusion came from the CRASH data set representingthe world in general, whereas such effects were not present in the Bangladesh data set. Additional application ofparametric bootstrapping for the smaller Bangladesh data set did not result into any significant outcome.

Conclusion: The effect of gender and age could be stronger in some countries than others which is driving thesignificance in CRASH and was not found in Bangladesh. It reflects the necessity of incorporating geographic patternsas well as demographic features of patients while developing treatments and designing clinical trials.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Published version made available under Creative Commons Attribution License 4.0.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Agricultural, Computational and Environmental Sciences
Date Deposited: 12 Jan 2018 05:24
Last Modified: 08 May 2018 00:07
Uncontrolled Keywords: public health, Glasgow outcome scale, health geography, Bangladesh, ordinal outcome scale
Fields of Research : 01 Mathematical Sciences > 0104 Statistics > 010401 Applied Statistics
11 Medical and Health Sciences > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases
01 Mathematical Sciences > 0104 Statistics > 010402 Biostatistics
Identification Number or DOI: 10.1186/s13690-017-0211-y
URI: http://eprints.usq.edu.au/id/eprint/33557

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