Browsing by Author "Yang, Yun-Ju"

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Psychiatric Disorders After Traumatic Brain Injury: A Nationwide Population-Based Cohort Study and the Effects of Rehabilitation Therapies
(2020-05-01)
Yeh, Ta-Chuan
;
Chien, Wu-Chien
;
Chung, Chi-Hsiang
;
Liang, Chih-Sung
;
Chang, Hsin-An
Objective: To investigate the risk of psychiatric disorders after traumatic brain injury (TBI), and to clarify whether the post-TBI rehabilitation was associated with a lower risk of developing psychiatric disorders. Design: A register-based, retrospective cohort design. Setting: Using data from the National Health Insurance Research Database of Taiwan, we established an exposed cohort with TBI and a nonexposed group without TBI matched by age and year of diagnosis between 2000 and 2015. Participants: This study included 231,894 patients with TBI and 695,682 patients without TBI (N=927,576). Interventions: Rehabilitation therapies in TBI patients. Main Outcome Measures: A multivariable Cox proportional hazards regression model was used to compare the risk of developing psychiatric disorders. Results: The incidence rate of psychiatric disorders was higher in the TBI group than the control group. Compared with the control group, the risk of psychiatric disorders in the TBI group was twofold (hazard ratio [HR] =2.072; 95% confidence interval [95% CI], 1.955-2.189; P<.001). Among the participants with TBI, 49,270 (21.25%) had received rehabilitation therapy and had a lower risk of psychiatric disorders (HR =0.691; 95% CI, 0.679-0.703; P<.001). In the subgroup analysis, the medium- to high-level intensity rehabilitation therapy was associated with lower risks of psychiatric disorder (HR =0.712 and 0.568, respectively), but there was no significant finding in the low-intensity group. Conclusions: We found that TBI was associated with a high risk for developing psychiatric disorders, and that the post-TBI rehabilitation significantly reduced the risk of psychiatric disorders in a dose-dependent manner. (C) 2020 by the American Congress of Rehabilitation Medicine.
Risk of Erectile Dysfunction After Traumatic Brain Injury: A Nationwide Population-Based Cohort study in Taiwan
(2018-07-01)
Yang, Yun-Ju
;
Chien, Wu-Chien
;
Chung, Chi-Hsiang
;
Hong, Kun-Ting
;
Yu, Yi-Lin
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.