Research Reports - Pituitary function and functional outcome in adults after severe traumatic brain injury: the long-term perspective
J Neurotrauma. 2013 Feb 15;30(4):271-80
Ulfarsson T, Arnar Gudnason G, Rosén T, Blomstrand C, Stibrant Sunnerhagen K, Lundgren-Nilsson A, Nilsson M.
Abstract Post-traumatic hypopituitarism (PTHP) has been linked to disability and
decreased quality of life. However, no studies have addressed the long-term
consequences of PTHP in adults with severe traumatic brain injury (TBI) only. In
this study, we evaluated the relationship between pituitary function, quality of
life, and functioning in 51 patients (16-65 years of age) with severe TBI who
were admitted to Sahlgrenska University Hospital, Gothenburg from 1999 to 2002.
The patients were assessed once, 2-10 years after trauma. Data from the time of
injury were collected retrospectively to adjust for injury severity. Outcome
measures included hormonal testing, the Short Form-36 Health Survey, the Glasgow
Outcome Scale-Extended, and a self-report questionnaire specifically designed for
this study and based on the International Classification of Functioning,
Disability and Health. Of 51 patients, 14 (27.5%) presented with PTHP, and 11
(21.6%) had isolated growth hormone deficiency. Patients with PTHP were more
often overweight at follow-up (p=0.01); the higher body mass index was partially
explained by PTHP (R(2) change=0.07, p=0.001). Otherwise no significant
correlation was found among PTHP, functioning, or patient-reported quality of
life. This study-which is unique in the homogeneity of the patients, the long
follow-up time, and the use of injury severity as an outcome predictor-did not
confirm results from previous studies linking PTHP to a worse outcome. Therefore,
screening for PTHP might be restricted to specific subgroups such as overweight
patients, indicating growth hormone deficiency.