@article{ref1,
title="Can early clinical parameters predict post-traumatic pituitary dysfunction in severe traumatic brain injury?",
journal="Acta neurochirurgica",
year="2016",
author="Nemes, O. and Kovács, N. and Szujo, Sz and Bodis, B. and Bajnok, L. and Buki, A. and Doczi, T. and Czeiter, E. and Mezosi, E.",
volume="158",
number="12",
pages="2347-2353",
abstract="BACKGROUND: Post-traumatic hypopituitarism is a major complication after severe head trauma. The aim of our study was to evaluate the possible role of early clinical parameters in the development of endocrine deficits. <br><br>METHODS: Data on endocrine function, on-admission clinical-, laboratory-, and ICU-monitored parameters were available in 63 patients of the surviving 86 severe head injury patients (post-resuscitation GCS under 8) treated at one neurosurgical center during a 10-year period. <br><br>RESULTS: Hypopituitarism was diagnosed in 68.3 % of the patients. The most frequently affected pituitary axis was the growth hormone (GH): GH deficiency or insufficiency was present in 50.8 %. Central hypogonadism affected 23.8 % of male patients; hypothyroidism and secondary adrenal failure were found in 22.2 and 9.5 % of the investigated population, respectively. Early onset (within 1 year of brain injury) hypopituitarism was found in 24 patients. No connection was found between the development of hypopituitarism and any of the clinical parameters assessed on-admission or at ICU. Significant correlations were found between early endocrine dysfunctions and surgical intervention (OR: 4.64) and the diagnosis of subdural hematoma (OR: 12). In our population, after road traffic accidents, the development of late-onset hypopituitarism was less prevalent (OR: 0.22). <br><br>CONCLUSIONS: Since our results do not indicate any reliable predictive parameter for the development of endocrine dysfunction in a cohort of patients with severe traumatic brain injury, regular endocrine screening of this specific patient population seems obligatory.<p /> <p>Language: en</p>",
language="en",
issn="0001-6268",
doi="10.1007/s00701-016-2995-x",
url="http://dx.doi.org/10.1007/s00701-016-2995-x"
}