Acute Neuroendocrine Profile in Predicting Outcomes in Severe Traumatic Brain Injury: A Study from a Tertiary Care Center in South India.

Autor: Vishwa Kumar KS; Department of Neurosurgery, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India., Mudumba VS; Department of Neurosurgery, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India., Alugolu R; Department of Neurosurgery, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India., Anne B; Department of Endocrinology, Nizams Institute of Medical Sciences, Punjagutta, Hyderabad, Telangana, India.
Jazyk: angličtina
Zdroj: Indian journal of endocrinology and metabolism [Indian J Endocrinol Metab] 2021 Mar-Apr; Vol. 25 (2), pp. 95-102. Date of Electronic Publication: 2021 Sep 08.
DOI: 10.4103/ijem.ijem_194_21
Abstrakt: Background: Pituitary dysfunction following severe traumatic brain injury (sTBI) is significant and may be correlated with the outcomes.
Aims and Objectives: This study aimed to evaluate the early changes in pituitary hormone levels after sTBI and to correlate with outcomes in terms of severity and mortality.
Methods: This was a prospective, observational study, involving consecutive patients of 16-60 years, with sTBI (Glasgow Coma Scale GCS < 9) presenting to the hospital within 24 h of trauma. Demographic and clinical data were collected. Serum samples were collected in the morning (08-10 am) on day 1 and day 4 for cortisol, thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and prolactin (Chemiluminescence immunoassay). Outcome was assessed in terms of mortality (which included both immediate and at 3 months) and Glasgow outcome scale at 3 months.
Results: 54 patients were studied. Mean cortisol on day 4 was 28.5 μg/dL in alive patients and 13.7 μg/dL in patients deceased at 3 months ( P < 0.001). Patients who were deceased at 3 months had significantly lower T3 on day 4 (0.973 vs 1.4 ng/dL) and lower T4 (8.1 μg/L vs 6.1 μg/dL) as compared to patients who survived ( P = 0.049 and 0.005, respectively). Acute phase TSH on day 4 levels were significantly lower in patients deceased at 3 months. There was no significant difference in the prolactin levels.
Conclusion: Day 4 cortisol, T3, T4, and TSH correlated with the outcomes at 3 months and hence have predictive value post-sTBI.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2021 Indian Journal of Endocrinology and Metabolism.)
Databáze: MEDLINE
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