Endocrine dysfunction following traumatic brain injury: a 5-year follow-up nationwide-based study.
Post-traumatic endocrine dysfunction is a complication of traumatic brain injury (TBI). However, there is lack of long-term follow-up and large sample size studies. This study included patients suffering from TBI registered in the Health Insurance Database. Endocrine disorders were identified using the ICD codes: 244 (acquired hypothyroidism), 253 (pituitary dysfunction), 255 (disorders of the adrenal glands), 258 (polyglandular dysfunction), and 259 (other endocrine disorders) with at least three outpatient visits within 1 year or one admission diagnosis. Overall, 156,945 insured subjects were included in the final analysis. The 1- and 5-year incidence rates of post-traumatic endocrinopathies were 0.4% and 2%, respectively. The risks of developing a common endocrinopathy (p < 0.001) or pituitary dysfunction (P < 0.001) were significantly higher in patients with a TBI history. Patients with a skull bone fracture had a higher risk of developing pituitary dysfunction at the 1-year follow up (p value < 0.001). At the 5-year follow up, the association between intracranial hemorrhage and pituitary dysfunction (p value: 0.002) was significant. The risk of developing endocrine dysfunction after TBI increased during the entire 5-year follow-up period. Skull bone fracture and intracranial hemorrhage may be associated with short and long-term post-traumatic pituitary dysfunction, respectively.
Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi Center, Taiwan.
Wei-Hsun
WH
Yang
Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.|Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Pau-Chung
PC
Chen
Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi Center, Taiwan.
Ting-Chung
TC
Wang
Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Ting-Yu
TY
Kuo
Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi Center, Taiwan.
Chun-Yu
CY
Cheng
Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.|Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan.|Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan.|School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Yao-Hsu
YH
Yang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004700:Endocrine System Diseases / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012887:Skull Fractures / Q000150:complications*; D014481:United States / Q000453:epidemiology; D055815:Young Adult