Hypogonadism Following Traumatic Brain Injury: A Population-Based Case Control Study Among Active Duty Male Service Members

You have accessJournal of UrologySexual Function/Dysfunction: Medical, Hormonal & Non-surgical Therapy I (PD20)1 Sep 2021PD20-03 HYPOGONADISM FOLLOWING TRAUMATIC BRAIN INJURY: A POPULATION-BASED CASE CONTROL STUDY AMONG ACTIVE DUTY MALE SERVICE MEMBERS Charles Rinehart, and Matthew Christman Charles RinehartCharles Rinehart More articles by this author , and Matthew ChristmanMatthew Christman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002009.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: No large-scale studies have specifically looked at the association between traumatic brain injury (TBI) and hypogonadism in the active duty military population. This gap is important given the high prevalence of TBI among active duty military members. Since 2000, more than 380,000 incident diagnoses of TBI have been reported among US military veterans with estimated rates of 11-23% among deployed service members. Given this high prevalence it would be of significant value to further understand the downstream consequences of what has been called the “signature injury” of recent conflicts. METHODS: We conducted a population-based case-control study to estimate the association between hypogonadism and TBI. Our population consisted of active duty males in service between 2014 and 2018. Cases included all males with an incident diagnosis of hypogonadism who were also dispensed a prescription for testosterone or clomiphene citrate within one year of the diagnosis. Three controls were matched to each case and were selected from active duty males who were in the same age quinquennia as the case when the hypogonadism diagnosis was made and who had no prior diagnosis or treatment for hypogonadism. Controls were also matched to cases by military branch of service and race. Conditional logistic regression was performed to ascertain the association of TBI and hypogonadism, controlling for the possible effects of TBI severity, year of TBI, time from first TBI to diagnosis of hypogonadism, marital status, number of deployments, and military occupation. RESULTS: In total, 5,114 cases and 15,342 controls were identified. After adjusting for the effects of covariates, we found that active duty males with a history of TBI experienced more than twice the odds of developing hypogonadism than those active duty males with no prior TBI exposure (OR 2.3; 95% CI: 2.1, 2.6). When covariate interactions were included in the logistic model, a statistically significant decreasing effect of TBI was seen with increasing age (2.5, 2.1, and 1.3 for age groups <25, 25-34, and 35+, respectively). CONCLUSIONS: In this large-scale study we found that active duty males with a history of TBI, when compared with healthy counterparts, were more than two times as likely to have been diagnosed with hypogonadism. These concerning results should prompt all clinicians, particularly those within the military, to consider hypogonadism among men with any prior TBI. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e368-e368 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Charles Rinehart More articles by this author Matthew Christman More articles by this author Expand All Advertisement Loading ...