Male veterans more likely to have headache related to trauma than female
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Headache disorders in American veterans were higher for men than women in incidence related to trauma, but men had fewer encounters for headaches and fewer visits to headache specialists, according to a study published in Neurology.
“Headache disorders are problematic in veterans beyond the high rates of primary headache disorders,” Jason Jonathon Sico, MD, MHS, FAHA, of the neurology service at VA Connecticut Healthcare System and the department of neurology at Yale School of Medicine, and colleagues wrote. “Traumatic brain injury (TBI) or other injuries sustained during deployment can lead to headache. Other military-related exposures may increase headache risk.”
Sico and fellow researchers sought to determine gender differences in headache types, sociodemographic characteristics, military campaign and exposures, and health care use among former U.S. military personnel in the Veterans Health Administration (VHA).
They conducted a retrospective cohort study and examined VHA electronic health record (EHR) data for 1,524,960 veterans (82.8% male) who had at least one visit for any headache between 2008 and 2019. Researchers divided headache diagnoses into eight categories using ICD codes, and gathered information from EHRs about demographics, military-related exposures, comorbidities and type of provider(s) consulted, which they compared by gender. Age-adjusted incidence and prevalence rates of medically diagnosed headache disorders were calculated separately for each type of headache.
According to results, compared with women, men were more often white (70.4% vs. 56.7%), older (52 ± 16.8 vs. 41.9 ± 13 years) and had higher rates of TBI (2.9% vs. 1.1%) and PTSD (23.7% vs. 21.7%). However, men had lower rates of military sexual trauma than women (3.2% vs 33.7%).
Researchers determined that age-adjusted incidence rate of headache of any type was higher among women, but that men were more likely than women to be diagnosed with headache not-otherwise-specified (77.4% vs. 67.7%) and have higher incidence rates of headaches related to trauma (3.4% vs. 1.9% [post-traumatic] and 5.5% vs. 5.1% [post-whiplash]).
Compared with women, men also had fewer headache types diagnosed (mean, 1.3 vs. 1.5), had fewer encounters for headache per year (0.8 vs. 1.2) and fewer visits to headache specialists (20.8% vs. 27.4%).
Emergency department use for headache care was high for both men and women, but higher for women (20.3% vs. 22.9%).
“Large scale educational interventions focusing on accurate and specific headache diagnoses and coding, alone or in combination with EHR/informatics-based approaches, could begin addressing this important and previously underappreciated issue among veterans,” Sico and colleagues wrote.