Research Reports - Risk of erectile dysfunction after traumatic brain injury

Yun-Ju Yang, MD, Wu-Chien Chien, PhD, Chi-Hsiang Chung, PhD, Kun-Ting Hong, MD, Yi-Lin Yu, MD, Dueng-Yuan Hueng, MD, PhD, Yuan-Hao Chen, MD, PhD, Hsin-I Ma, MD, PhD, Hsin-An Chang, MD, Yu-Chen Kao, MD, MSc, Hui-Wen Yeh, RN, MSN, Nian-Sheng Tzeng, MD

American Journal of Men's Health
January 11, 2018

Introduction:
In our study, we aimed to investigate the association between a traumatic brain injury (TBI) and subsequent erectile dysfunction (ED). This is a population-based study using the claims dataset from The National Health Insurance Research Database.

Methods:
We included 72,642 patients with TBI aged over 20 years, retrospectively, selected from the longitudinal health insurance database during 2000–2010, according to the ICD-9-CM. The control group consisted of 217,872 patients without TBI that were randomly chosen from the database at a ratio of 1:3, with age- and index year matched. Cox proportional hazards analysis was used to estimate the association between the TBI and subsequent ED.

Results:
After a 10-year follow-up, the incidence rate of ED was higher in the TBI patients when compared with the non-TBI control group (24.66 and 19.07 per 100,000, respectively). Patients with TBI had a higher risk of developing ED than the non-TBI cohort after the adjustment of the confounding factors, such as age, comorbidity, residence of urbanization and locations, seasons, level of care, and insured premiums (adjusted hazard ratio (HR) = 2.569, 95% CI [1.890, 3.492], p < .001).

Conclusion:
This is the first study using a comprehensive nationwide database to analyze the association of ED and TBI in the Asian population. After adjusted the confounding factors, patients with TBI have a significantly higher risk of developing ED, especially organic ED, than the general population. This finding might remind clinicians that it’s crucial in early identification and treatment of ED in post-TBI patients.

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