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Risk Factors for Anterior Hypopituitarism in Patients With Traumatic Brain Injury
Abstract
Background: Hypopituitarism is a common but potentially undiagnosed complication in patients who suffer traumatic brain injury (TBI). The identification of risk factors of hypopituitarism after TBI is vital to establish a rational testing approach for these patients. Methods: The authors retrospectively reviewed the case records of patients with TBI, who underwent pituitary function evaluation in our department between January 2014 and December 2016. Results: In all, 193 patients (66.3% male) hospitalized with TBI were included in this study. Anterior hypopituitarism was observed in 33 (17.1%) patients, with 4.7% of the patients having multiple pituitary axes dysfunction. Patients with hypopituitarism had a longer length of ICU stay (8.7 ± 5.5 versus 3.3 ± 4.6,P < 0.001), longer length of total hospital stay (28.7 ± 20.1 versus 21.0 ± 15.8,P = 0.011), and lower Glasgow coma scale (GCS) on admission (9.1 ± 3.5 versus 11.8 ± 3.6,P < 0.001) than those without the condition. Length of ICU stay (P = 0.004, OR = 1.253) and intracranial hypertension (P = 0.027, OR = 3.206) were independent risk factors for posttraumatic hypopituitarism. Conclusions: The prevalence of anterior hypopituitarism was estimated to be 17.1%. Patients with intracranial hypertension and longer length of ICU stay are at risk of hypopituitarism. Routine pituitary function evaluation is indicated for this group of patients.
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“The lack of clear data is probably a result of the varied design of the studies and the heterogeneity of the studied populations [7,8,9].”
From An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges (2023) · cites this paper as [8]
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Cites
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“The explanation for this difference is also multifactorial, including the different time interval between brain injury and assessment of pituitary function, the different type and severity of brain injury and different diagnostic tests and criteria for pituitary function.(28,29) According to guidelines,(30) the growth…”
BackgroundTan, C. L., Alavi, S. A., Baldeweg, S. E., Belli, A., Carson, A., Feeney, C., Goldstone, A. P., Greenwood, R., Menon, D. K., Simpson, H. L., et al. (2017) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2016-315500 · Cited by 111 · cited 1×
“Many questions arise concerning the definition of risky patients and estimation of the incidence rate of hypopituitarism.(21) In this present study, we found that the prevalence rate of anterior hypopituitarism in TBI patients was 17.”
BackgroundKrahulik, D., Zapletalova, J., Frysak, Z., & Vaverka, M. (2010) · Journal of Neurosurgery · doi:10.3171/2009.10.jns09930 · Cited by 108
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“In addition, some studies have also suggested the presence of diffuse brain swelling and basal fractures on initial CT were associated with higher prevalence of hypopituitarism.(7,13,32) However, we did not observe such association between them in this study.”
ResultHypopituitarism following severe traumatic brain injury
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Cited by
An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges
Vlad, R. M., Albu, A. I., Nicolaescu, I. D., Dobritoiu, R., Carsote, M., Sandru, F., Albu, D., & Păcurar, D. (2023) · Diagnostics · doi:10.3390/diagnostics13020212 · Cited by 7
Metadata
- Authors
- You, W., Zhu, Y., Wen, L., Sun, Y., Pan, D., & Yang, X.
- Affiliations
- Department of Neurosurgery
- Department of Rehabilitation Medicine, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
- Venue
- Journal of Craniofacial Surgery
- Published
- 2019-10
- Volume
- 30
- Issue
- 7
- Pages
- 2119-2123
- ISSN
- 1049-2275
- 1536-3732
- Cited by
- 9
- References
- 16
- Language
- en
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