All ETDs from UAB

Advisory Committee Chair

John Waterbor

Advisory Committee Members

Philip R Fine

Jeffrey Kerby

Steven G Lobello

Gerald McGwin

Document Type

Dissertation

Date of Award

2008

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Medical and rehabilitative care of women living with traumatic brain injury (TBI) is based on information drawn from research conducted primarily on men. Care for men may be adequate for women, but all of the body’s organs have the capability to respond differently based on gender, and research should examine the genders separately. This dissertation examines the survival to 24 months post-TBI and the functional independence and employment status at 12 and 24 months post-TBI of men and women. Participants were drawn from a longitudinal study of injured persons and include those diagnosed only with a TBI. Variables used in these analyses were abstracted from medical records, self-reported, or obtained through the National Death Index. Mortality was documented with the National Death Index. Functional independence and employment status were self or proxy reported during the 12 and 24 month follow-up interviews. Functional independence was measured with the Functional Independence Measure (FIM). Between 24 hours and 24 months post-injury, gender was not associated with mortality after adjusting for age, head injury severity and type of head injury. The functional independence analyses were stratified by respondent (participant or iii proxy). Gender was not associated with post-injury functional independence when the participant responded to the follow-up questionnaire at 12 or 24 months post-injury after adjusting for injury and demographic factors. When a proxy responded to the follow-up questionnaire, female gender was associated with a 13% decrease in average FIM score at 12 months post-injury (p=0.0198), but not at 24 months post-injury after adjusting for other relevant variables. Gender was not associated with employment status 12 or 24 months post-injury. Gender’s only role in the TBI outcomes examined was in level functional independence at 12 months, but only with a proxy response.

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