@article{ref1,
title="Growth hormone deficiency after traumatic brain injury: improvement in quality of life with GH therapy - analysis of the KIMS database",
journal="European journal of endocrinology",
year="2015",
author="Gardner, Chris John and Mattsson, Anders F. and Daousi, Christina and Korbonits, Marta and Koltowska-Haggstrom, Maria and Cuthbertson, Daniel J.",
volume="172",
number="4",
pages="371-381",
abstract="OBJECTIVE: Prevalence of growth hormone (GH) deficiency (GHD) caused by traumatic brain injury (TBI) is highly variable. Short-term studies show improvement in quality of life (QoL) during GH replacement (GHR), but long-term data are lacking. This study aimed to analyse the clinical characteristics of post traumatic hypopituitarism and the QoL effects of long-term GHR. Design/Methods: KIMS (Pfizer International Metabolic Database) patients with GHD caused by TBI and by non-functioning pituitary adenoma (NFPA) were compared regarding: clinical characteristics at baseline and 1-year of GHR, and QoL response up to 8-years of GHR (QoL-AGHDA total scores and dimensions) in relation to country-specific norms. <br><br>RESULTS: TBI patients compared to NFPA patients: were younger, diagnosed with GHD 2.4 years later after primary disease onset (p<0.0001), had a higher incidence of isolated GHD, higher GH peak, a more favourable metabolic profile and worse QoL, were shorter by 0.9 cm (1.8 cm when corrected for age and gender; p=0.004) and received higher GH dose (mean difference: 0.04 mg/day p=0.006). In TBI patients, 1-year improvement in QoL, was greater than in NFPA (change in QoL-AGHDA score 5.0 vs. 3.5, respectively, p=0.04) and was sustained over 8-years. In TBI patients, socialisation normalised after 1 year of GHR, self-confidence and tenseness after 6 years and no normalisation of tiredness and memory was observed. <br><br>CONCLUSION: Compared to NFPA, TBI patients presented biochemically with less severe hypopituitarism and worse QoL scores. GHR achieved clinically relevant, long-term benefit in QoL.<p /> <p>Language: en</p>",
language="en",
issn="0804-4643",
doi="10.1530/EJE-14-0654",
url="http://dx.doi.org/10.1530/EJE-14-0654"
}