Evidence map›Paper›PMID 42529561›Full record

ReviewBrain & spine2026

Sex differences in patient mortality after traumatic spinal cord injury: A systematic review and meta-analysis.

Elise Beijer, Floor J Mansvelder, Romein W G Dujardin, Nicole P Juffermans, Linda J Schoonmade, Leo M G Geeraedts, Frank W Bloemers, Patrick Schober, Charissa E van den Brom

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Elise BeijerDept. of Surgery, Section Trauma Surgery, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
Floor J MansvelderDept. of Anesthesiology, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
Romein W G DujardinDept. of Anesthesiology, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
Nicole P JuffermansDept of. Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, Rotterdam, the Netherlands.
Linda J SchoonmadeMedical Library, VU University Amsterdam, Amsterdam, the Netherlands.
Leo M G GeeraedtsDept. of Surgery, Section Trauma Surgery, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
Frank W BloemersDept. of Surgery, Section Trauma Surgery, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
Patrick SchoberDept. of Anesthesiology, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.
Charissa E van den BromDept. of Anesthesiology, Amsterdam University Medical Centers, VU University Amsterdam, de Boelelaan 1117, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Traumatic spinal cord injury (TSCI) causes high mortality and long-term disability, with profound physical, emotional, and socioeconomic impact. While males represent the majority of cases, females may have lower mortality, potentially due to neuroprotection and immune modulation. However, the impact of sex on mortality remains unclear, limiting opportunities for sex-specific management. Research question: To evaluate the association between sex and mortality after TSCI. Material and methods: PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched on June 4, 2025. Observational studies reporting sex-stratified mortality in TSCI across all ages and injury severities were included. Screening and data extraction were performed independently by multiple reviewers. Random-effects meta-analysis calculated odds ratios (OR) for mortality in females versus males, with leave-one-out sensitivity analyses. Heterogeneity was assessed using I Results: Ten studies including 63,992 patients (18,788 females and 45,204 males) were analyzed, with no evidence of small study bias. Sex was not significantly associated with TSCI mortality (OR 0.86, 95% CI 0.69-1.07, p = 0.18). Sensitivity analyses and qualitative evaluation of individual studies (six of ten, adjusted analyses) indicated lower mortality in females. Substantial heterogeneity was observed (I Discussion and conclusion: Overall, sex was not associated with TSCI mortality. Nevertheless, individual studies and sensitivity analyses indicate lower mortality in females. These findings appear context-dependent, underscoring the need for future research to clarify when sex influences outcomes, supporting individualized risk stratification and sex-specific management.

Indexed as

MortalitySex differencesSurvivalTrauma injuryTraumatic spinal cord injury (TSCI)

Identifiers

PMID42529561
PMCPMC13418270

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.