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青年男性综合征——重度创伤性脑损伤患者的性别、年龄、冒险行为及死亡率分析

The Young Male Syndrome-An Analysis of Sex, Age, Risk Taking and Mortality in Patients With Severe Traumatic Brain Injuries.

作者信息

Tamás Viktória, Kocsor Ferenc, Gyuris Petra, Kovács Noémi, Czeiter Endre, Büki András

机构信息

Department of Neurosurgery, Medical School, University of Pécs, Pécs, Hungary.

Faculty of Humanities, Institute of Psychology, University of Pécs, Pécs, Hungary.

出版信息

Front Neurol. 2019 Apr 12;10:366. doi: 10.3389/fneur.2019.00366. eCollection 2019.

Abstract

Higher risk taking is particularly characteristic for males between 15 and 35 years, the age when intrasexual competition is the strongest. This fitness-maximizing strategy, however, also has negative consequences; previous data revealed that males have a significantly higher tendency to die in accidents. This retrospective study aimed to assess whether age-related risk taking, often associated with the reproductive competition between males, and referred to as the Young Male Syndrome (YMS), may play a role in the high incidence of severe traumatic brain injury (sTBI) in young males. Derived from the available evidence and the main assumptions of the YMS, we expected that men, especially when they are in the age when their reproductive potential peaks, are more likely to suffer sTBI from highly risky behaviors that also lead to higher mortality. It was also expected that alcohol intoxication makes the demographic pattern of sTBI even more similar to what previous research on the YMS implies. We analyzed demographic data of patients with sTBI ( = 365) registered in a clinical database. To this end, we built Generalized Linear Mixed Models (GLMM) to reveal which of the demographic characteristics are the best predictors for risky behaviors leading to sTBI and death as a consequence of the injury. The data suggest that younger people acquired sTBI from riskier behaviors compared to members of older age groups, irrespective of their sex. Moreover, being male and being alcohol intoxicated also contributed significantly to risk-taking behavior. Mortality rate after the injury, however, increased with the age of the patient and did not depend on the riskiness of the behavior. The results indicate that the demographic distribution of the specific patient population in our focus cannot be simply explained by the YMS. However, higher incidence rates of males among the patients are in line with the core assumptions of the YMS. These data indicate that epidemiological studies should also take into consideration evolutionary theories and highlight the importance of age and sex specific prevention strategies.

摘要

高风险行为尤其在15至35岁的男性中较为常见,这一年龄段的男性内部性竞争最为激烈。然而,这种使适应性最大化的策略也有负面后果;先前的数据显示,男性在事故中死亡的倾向明显更高。这项回顾性研究旨在评估与男性生殖竞争相关的、常被称为青年男性综合征(YMS)的与年龄相关的冒险行为,是否可能在青年男性严重创伤性脑损伤(sTBI)的高发病率中起作用。基于现有证据和YMS的主要假设,我们预期男性,尤其是在其生殖潜力达到峰值的年龄,更有可能因高风险行为而遭受sTBI,这些行为也会导致更高的死亡率。我们还预期酒精中毒会使sTBI的人口统计学模式与先前关于YMS的研究所暗示的更加相似。我们分析了临床数据库中登记的sTBI患者(n = 365)的人口统计学数据。为此,我们构建了广义线性混合模型(GLMM),以揭示哪些人口统计学特征是导致sTBI及因伤死亡的高风险行为的最佳预测因素。数据表明,与年龄较大的人群相比,年轻人因更具风险的行为而遭受sTBI,无论其性别如何。此外,男性和酒精中毒也显著促成了冒险行为。然而,受伤后的死亡率随患者年龄增加而上升,且不取决于行为的风险程度。结果表明,我们所关注的特定患者群体的人口统计学分布不能简单地用YMS来解释。然而,患者中男性的较高发病率与YMS的核心假设一致。这些数据表明,流行病学研究也应考虑进化理论,并强调针对年龄和性别的预防策略的重要性。

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