Persistent hypogonadotropic hypogonadism in men after severe traumatic brain injury: temporal hormone profiles and outcome prediction
Published Date:2016 Jul-Aug
Source:J Head Trauma Rehabil. 31(4):277-287.
Pubmed Central ID:PMC4786474
Funding:R49 CE323155/CE/NCIPC CDC HHS/United States
(1) Examine relationships between persistent hypogonadotropic hypogonadism (PHH) and long-term outcomes after severe traumatic brain injury (TBI); (2) determine if sub-acute testosterone levels can predict PHH.
Level 1 trauma center at a university hospital.
Consecutive sample of men with severe TBI between 2004 and 2009.
Prospective cohort study.
Post-TBI blood samples were collected during week 1, every 2 weeks until 26 weeks, and at 52 weeks. Serum hormone levels were measured, and individuals were designated as having PHH if ≥50% of samples met criteria for hypogonadotropic hypogonadism. At 6 and 12 months post-injury, we assessed global outcome, disability, functional cognition, depression, and quality-of-life.
We recruited 78 men; median (IQR) age was 28.5 (22–42) years. 34 patients (44%) had PHH during the first year post-injury. Multivariable regression, controlling for age, demonstrated PHH status predicted worse global outcome scores, more disability, and reduced functional cognition at 6 and 12 months post-TBI. Two-step testosterone screening for PHH at 12–16 weeks post-injury yielded a sensitivity of 79% and specificity of 100%.
PHH status in men predicts poor outcome after severe TBI, and PHH can accurately be predicted at 12–16 weeks.
Supporting Files:No Additional Files
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