Abstract
We investigated the association between head computed tomography (CT) scans and the risk of noncancer thyroid diseases in patients with minor head injury in a Taiwanese healthcare setting. For this retrospective population-based cohort study, the 2009–2013 Longitudinal Health Insurance Database was used to include patients with a minor head injury at admission or emergency visit between 2009 and 2013. Multivariate analysis with a multiple Cox regression model was applied to analyze the data. According to whether a CT scan was conducted within 14 days of admission, patients were divided into a CT scan group (n = 14,041) or a non-CT scan group (n = 34,684). No increased incidence of thyroid diseases was observed in the CT scan group regardless of the number of CT scans performed. The incidence rate ratio for one scan was 1.10 (95% confidence interval: 0.94–1.29) and for two or more scans was 1.09 (95% confidence interval: 0.93–1.28). In conclusion, this population-based cohort study showed that a head CT scan is not associated with increased risk of thyroid disease in patients with minor head injury. The short-term adverse effects on the thyroid could be mild when a regular CT scan is appropriately performed.
Highlights
Traumatic brain injuries (TBIs) frequently occur in Taiwan, causing serious short- and long-term sequelae in affected persons and socioeconomic burdens on their families and society
Since thyroid dysfunction may be affected by several factors in patients with moderate-to-severe head injury, including brain injury [9,10,11], shock status [12], medication such as glucocorticoids and dopamine agonists [13], and massive transfusion [14], we focused on potential thyroid diseases induced by radiation in patients with minor head injuries undergoing a head computed tomography (CT) scan
We identified 48,725 patients who had visited the emergency department or had been admitted to the hospital due to a minor head injury from 2009 to 2013; 14,041 (28.82%) of them underwent a CT
Summary
Traumatic brain injuries (TBIs) frequently occur in Taiwan, causing serious short- and long-term sequelae in affected persons and socioeconomic burdens on their families and society. 2.8 million patients have experienced traumatic head injuries in the United States and TBIs caused more than 56,000 deaths every year from 2007 to 2013 [1]. In Taiwan, the incidence and death rate of TBI was 220.6/100,000 and 11.8/100,000 population in these years, respectively [2]. Minor head injury is considered when a patient with a TBI has a history of loss of consciousness, amnesia, or disorientation and a Glasgow Coma Scale score of 13–15 [3]. Res. Public Health 2020, 17, 3873; doi:10.3390/ijerph17113873 www.mdpi.com/journal/ijerph
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