Peripheral trauma and risk of dystonia: What are the evidences and potential co-risk factors from a population insurance database?

PLoS One. 2019 May 10;14(5):e0216772. doi: 10.1371/journal.pone.0216772. eCollection 2019.

Abstract

Background: Dystonia is a neurological syndrome typically resulting in abnormal postures.

Objectives: We tested the role of physical injury as potential risk factor for development of dystonia using The National Health Insurance Research Database of Taiwan.

Methods: We identified 65704 people who were coded in the database as having had peripheral traumatic injuries (ICD-9-CM 807-848 and 860-959) in the year 2000. Patients with traumatic brain or spine injuries were excluded from analysis. We matched them using purposive sampling with 65704 people in the database who had not suffered peripheral trauma. We looked then at the incidence of dystonia occurring at least 1 year from the date of the peripheral trauma until 2011. Psychiatric symptoms (depression and anxiety) and sleeps difficulties have been investigated as potential covariates.

Results: We found 189 patients with dystonia (0.28%) in the trauma group, and 52 patients with dystonia (0.08%) in the non-trauma group. Trauma was independently associated with dystonia (adjusted HR = 3.12, 95% CI = 2.30-4.24). The incidence density of dystonia in the trauma group was 2.27 per 10000 person-years, while it was 0.71 per 10000 person-years in the non-trauma group Beyond the peripheral trauma, other variables associated to the incidence of dystonia included female sex, aged 40 years and above, depression and sleep disorders.

Conclusion: These data from a large population dataset support traumatic injury as a risk factor for the development of dystonia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Databases, Factual*
  • Dystonic Disorders / complications*
  • Dystonic Disorders / economics
  • Dystonic Disorders / epidemiology*
  • Female
  • Humans
  • Incidence
  • Insurance, Health / statistics & numerical data*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Wounds and Injuries / complications*
  • Young Adult

Grants and funding

Funding for this study was provided by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW106-TDU-B-212-113004), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10601010036), Taiwan Clinical Trial Consortium for Stroke (MOST 106-2321-B-039-005), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo, Kiyo Aoshima Memorial Funds, Japan, MOST 105-2911-I-039 -501, 105-2911-I-039-505, DMR-105-181, DMR-106-205, MOST 105-2632-B-039-003-, MOST 105-2314-B-039-005-MY2 and CMU104-N-12. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.