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Trauma and thyroid-stimulating hormone abnormalities in pediatric patients
Abstract
Background: There is limited literature on trauma and endocrine abnormalities in the pediatric trauma setting. Aim: We studied demographic, medical history, injury experience, and mortality factors to determine their association with abnormal thyroid-stimulating hormone in pediatric trauma patients. Methods: The 414 pediatric trauma patients were from those seen at an emergency department. The primary outcome variable was abnormal thyroid-stimulating hormone. Secondary outcome variables were abnormal high and abnormal low thyroid-stimulating hormone. Predictor variables were demographics (age, sex, race/ethnicity, body mass index), medical history (thyroid disease, diabetes mellitus, autoimmune disease, psychiatric disease), injury experience (injury cause, injury severity score ≥ 15, moderate/severe traumatic brain injury, length of stay), and mortality (mortality, survival probability). Multivariate logistic regression analyses were conducted. Results: There were 8.0% ( n = 33) with any abnormal thyroid-stimulating hormone value. In the analysis for abnormal thyroid-stimulating hormone, females (odds ratio:4.95, 95% confidence interval: 2.01, 12.21, p < 0.01) and traumatic brain injury (odds ratio: 8.11, 95% confidence interval: 2.51, 26.16, p < 0.001) were each significantly associated with increased odds. In the analysis for abnormal high thyroid-stimulating hormone (odds ratio: 3.75, 95% confidence interval: 1.37, 10.24, p < 0.05), traumatic brain injury (odds ratio: 11.59, 95% confidence interval: 3.45, 38.97, p < 0.001), and mortality (odds ratio: 35.59, 95% confidence interval: 1.40, 906.57, p < 0.05) were each significantly associated with increased odds. In the analysis for abnormal low thyroid-stimulating hormone, only females (odds ratio: 11.10, 95% confidence interval: 1.26, 97.60, p < 0.05) were significantly associated with increased odds. Conclusion: In conclusion, females and traumatic brain injury have increased odds for abnormal thyroid-stimulating hormone. Mortality has increased odds for abnormal high thyroid-stimulating hormone. We suggest that clinicians in the pediatric trauma setting carefully monitor females and traumatic brain injury patients with abnormal thyroid-stimulating hormone.
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“Out of 414 pediatric patients with moderate-to-severe TBI, 33 had abnormal TSH levels, with the majority (78.8%) of these patients having high TSH.”
From Acute neuroendocrine changes after traumatic brain injury (2024) · cites this paper as Aggarwal et al., 2020
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“This abnormal elevation in TSH could act as an early indicator of the severity of head trauma, sometimes referred to as ‘pituitary concussion’ and might be associated with a poorer prognosis.”
From Acute neuroendocrine changes after traumatic brain injury (2024) · cites this paper as Aggarwal et al., 2020
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“Similar to adults, a higher incidence of TSH abnormalities was noted in female patients, possibly linked to the natural hormonal fluctuations in female physiology (Aggarwal et al., 2020).”
From Acute neuroendocrine changes after traumatic brain injury (2024) · cites this paper as Aggarwal et al., 2020
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Cited by
Acute neuroendocrine changes after traumatic brain injury
Magyar-Sumegi, Z. D., Stankovics, L., Lendvai-Emmert, D., Czigler, A., Hegedus, E., Csendes, M., Toth, L., Ungvari, Z., Buki, A., & Toth, P. (2024) · Brain and Spine · doi:10.1016/j.bas.2024.102830 · Cited by 23
Metadata
- Authors
- Aggarwal, S., Fogel, J., Kumar, K., & Shabbir, N.
- Affiliations
- Department of Pediatrics, Nassau University Medical Center, East Meadow, NY, USA
- ORCID
- Shabbir, Nadeem
- Venue
- Trauma
- Publisher
- SAGE Publications
- Published
- 2019-05-09
- Volume
- 22
- Issue
- 2
- Pages
- 118-125
- ISSN
- 1460-4086
- 1477-0350
- Cited by
- 1
- References
- 17
- Language
- en
- Licence
- journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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