Study Warns Women With Brain Injuries May Be Missing Specialist Trauma Care

A new CMAJ study has raised serious questions about gender equity in emergency trauma systems after finding that women hospitalised with traumatic brain injury were significantly less likely than men to be admitted to a specialised trauma centre. Researchers analysed 55,606 traumatic brain injury patients admitted to hospitals in Ontario between April 2009 and March 2020 and found that, overall, only 18,650 were admitted to a specialised trauma centre; among them, just 26% of female patients received that level of care compared with 38% of male patients. Female patients were also older on average, with a median age of 78 compared with 67 for men and were more likely to have conditions such as dementia and hypertension, which may influence how injuries are assessed. The concern is that brain injuries caused by lower-energy falls, especially in older women, may be underestimated by triage systems that are often designed around high-impact trauma such as vehicle crashes or severe visible injuries. While the study does not prove deliberate bias, it suggests that emergency pathways may unintentionally route women away from specialist trauma services, potentially delaying neurosurgical assessment, advanced imaging, rehabilitation planning and coordinated recovery care. The findings are a reminder that equity in emergency medicine is not only about access to hospitals, but about whether every patient's injury is recognised as serious enough to receive the right level of specialist care at the right time.