Research Reports - Endocrine dysfunction following traumatic brain injury
Sci Rep. 2016 Sep 9;6:32987. doi: 10.1038/srep32987.
Yang WH(1), Chen PC(2,)(3), Wang TC(1), Kuo TY(4), Cheng CY(1), Yang
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.