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Original Research

Open Access

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

  • Eujene Jung1
  • Hyun Ho Ryu2,*,
  • Gwan Jin Park3
  • Hanna Yoon4
  • Stephen Gyung Won Lee5
  • Sung Bae Moon6
  • Young Sun Ro4
  • Sang Do Shin7
  • Pan-Asian Trauma Outcomes Study for Traumatic Brain Injury (PATOS-TBI) research network

1Department of emergency medicine, Chonnam national university hospital, 61469 Gwangju, Republic of Korea

2Department of medicine, Chonnam national university, 61469 Gwangju, Republic of Korea

3Department of emergency medicine, Chungbuk national university hospital, 28644 Cheongju, Republic of Korea

4Department of emergency medicine, Seoul national university hospital, 03080 Seoul, Republic of Korea

5Department of emergency medicine, Seoul national university boramae medical center, 07061 Seoul, Republic of Korea

6Department of emergency medicine, Kyungpook national university and Kyungpook national university hospital, 41944 Daegu, Republic of Korea

7Department of medicine, Seoul national University, 03080 Seoul, Republic of Korea

DOI: 10.22514/jomh.2024.042 Vol.20,Issue 3,March 2024 pp.89-98

Submitted: 06 November 2023 Accepted: 01 December 2023

Published: 30 March 2024

*Corresponding Author(s): Hyun Ho Ryu E-mail:


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.


Sex; Obesity; TBI

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Eujene Jung,Hyun Ho Ryu,Gwan Jin Park,Hanna Yoon,Stephen Gyung Won Lee,Sung Bae Moon,Young Sun Ro,Sang Do Shin,Pan-Asian Trauma Outcomes Study for Traumatic Brain Injury (PATOS-TBI) research network. Sex-specific impacts of obesity on long-term prognosis of traumatic brain injury: a multicenter prospective study. Journal of Men's Health. 2024. 20(3);89-98.


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