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Pituitary Function and Functional Outcome in Adults after Severe Traumatic Brain Injury: The Long-Term Perspective.

Journal article
Authors Trandur Ulfarsson
Gudni Arnar Gudnason
Thord Rosén
Christian Blomstrand
Katharina S Sunnerhagen
Åsa Lundgren Nilsson
Michael Nilsson
Published in Journal of neurotrauma
Volume 30
Issue 4
Pages 271-280
ISSN 1557-9042
Publication year 2013
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 271-280
Language en
Subject categories Neurology


Posttraumatic 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 (age 16-65 years) 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 (R2 change = 0.07, p = 0.001). Otherwise no significant correlation was found between 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. Thus, screening for PTHP might be restricted to specific subgroups such as overweight patients, indicating growth hormone deficiency.

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