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    Epidemiology of Pediatric Traumatic Brain Injury and Hypothalamic-Pituitary Disorders in Arizona

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    Author
    Ortiz, J Bryce
    Sukhina, Alona
    Balkan, Baran
    Harootunian, Gevork
    Adelson, P David
    Lewis, Kara S
    Oatman, Oliver
    Subbian, Vignesh
    Rowe, Rachel K
    Lifshitz, Jonathan
    Affiliation
    Univ Arizona, Coll Med Phoenix, Dept Child Hlth, Translat Neurotrauma Res Program
    Univ Arizona, Coll Engn
    Issue Date
    2020-01-22
    Keywords
    adolescence
    concussion
    endocrine dysfunction
    head injury
    hypopituitarism
    pediatrics
    puberty
    traumatic brain injury
    
    Metadata
    Show full item record
    Publisher
    FRONTIERS MEDIA SA
    Citation
    Ortiz JB, Sukhina A, Balkan B, Harootunian G, Adelson PD, Lewis KS, Oatman O, Subbian V, Rowe RK and Lifshitz J (2020) Epidemiology of Pediatric Traumatic Brain Injury and Hypothalamic-Pituitary Disorders in Arizona. Front. Neurol. 10:1410. doi: 10.3389/fneur.2019.01410
    Journal
    FRONTIERS IN NEUROLOGY
    Rights
    Copyright © 2020 Ortiz, Sukhina, Balkan, Harootunian, Adelson, Lewis, Oatman, Subbian, Rowe and Lifshitz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Traumatic brain injury (TBI) in children can result in long-lasting social, cognitive, and neurological impairments. In adults, TBI can lead to endocrinopathies (endocrine system disorders), but this is infrequently reported in children. Untreated endocrinopathies can elevate risks of subsequent health issues, such that early detection in pediatric TBI survivors can initiate clinical interventions. To understand the risk of endocrinopathies following pediatric TBI, we identified patients who had experienced a TBI and subsequently developed a new-onset hypothalamic regulated endocrinopathy (n = 498). We hypothesized that pediatric patients who were diagnosed with a TBI were at higher risk of being diagnosed with a central endocrinopathy than those without a prior diagnosis of TBI. In our epidemiological assessment, we identified pediatric patients enrolled in the Arizona Health Care Cost Containment System (AHCCCS) from 2008 to 2014 who were diagnosed with one of 330 TBI International Classification of Diseases (ICD)-9 codes and subsequently diagnosed with one of 14 central endocrinopathy ICD-9 codes. Additionally, the ICD-9 code data from over 600,000 Arizona pediatric patients afforded an estimate of the incidence, prevalence, relative risk, odds ratio, and number needed to harm, regarding the development of a central endocrinopathy after sustaining a TBI in Arizona Medicaid pediatric patients. Children with a TBI diagnosis had 3.22 times the risk of a subsequent central endocrine diagnosis compared with the general population (±0.28). Pediatric AHCCCS patients with a central endocrine diagnosis had 3.2-fold higher odds of a history of a TBI diagnosis than those without an endocrine diagnosis (±0.29). Furthermore, the number of patients with a TBI diagnosis for one patient to receive a diagnosis of a central endocrine diagnosis was 151.2 (±6.12). Female subjects were more likely to present with a central endocrine diagnosis after a TBI diagnosis compared to male subjects (64.1 vs. 35.9%). These results are the first state-wide epidemiological study conducted to determine the risk of developing a hypothalamic-pituitary disorder after a TBI in the pediatric population. Our results contribute to a body of knowledge demonstrating a TBI etiology for idiopathic endocrine disorders, and thus advise physicians with regard to TBI follow-up care that includes preventive screening for endocrine disorders.
    Note
    Open access journal
    ISSN
    1664-2295
    PubMed ID
    32038466
    DOI
    10.3389/fneur.2019.01410
    Version
    Final published version
    ae974a485f413a2113503eed53cd6c53
    10.3389/fneur.2019.01410
    Scopus Count
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