Impact of Minority Female Status on operative Traumatic Brain Injury Outcome

Introduction: There has been few studies examining the impact of gender on operative TBI outcomes, and even fewer focused on minority females. This is the first study to examine the impact of minority female status on operative TBI outcomes.

Methods: To perform this retrospective study demographic, clinical, and outcome data were collected from all operative TBI patients between 2007 and 2021. Ethnic minority status was defined as non-White Hispanic, Black, and Asian. Non-operative TBIs were excluded. Income was determined according to the median annual income corresponding to the patient’s zip code.

Results: 220 individuals who received surgical intervention for TBI were used to compare minority females (14.55%) to all remaining patients (85.45%). There was no significant difference in median income (p=.66), and age (p=.83). Additionally, there was no significant difference in mRS at discharge (p=.97), mortality (p=.17), length of hospital stay (p=.47), or mRS on last follow up (p=.63). Minority females received more ICP monitors pre-op (p=.04) and a trend towards significance was shown with minority females being more likely to undergo craniectomy rather than craniotomy (p=.06).

A subgroup analysis comparing minority females (47.86%) and non-minority females (52.94%) was also performed. Minority females are younger than non-minority females (55 vs. 70 years old, respectively. p=.04). Additionally, minority females have a lower median income at $75,280 compared to non-minority females at $94,823 (p=.02). Non-minority females were significantly more likely to present with herniation on imaging (p=.03). There was no significant difference in mRS at discharge (p=.38), mortality (p=.84), length of hospital stay (p=.42), or mRS on last follow up (p=.20).

There was no significant differences across any of the variables when comparing minority females to minority males.

Conclusion : This study shows no significant difference in operative TBI outcomes between minority females when compared to both the remaining population and specifically to non-minority females. This is consistent with the delivery of equitable care at New England’s largest level 1 trauma center and safety net hospital.