Abstract
Introduction: To determine the prevalence of pituitary dysfunction following traumatic brain injury (TBI) and evaluate its assessment.
Methods: Data were retrospectively collected on 104 patients admitted to the Wessex Neurological Centre with TBI over 1-year. An electronic TBI database and patient notes were reviewed for endocrinological tests performed, results and deficiencies identified.
Results: Only 37.5% (n=39) of patients were assessed for any form of pituitary dysfunction. On average, these assessments only covered 1.9 of 6 clinically relevant pituitary hormones per patient. Of patients tested, 53.8% (n=21) were found to have pituitary dysfunction. ACTH deficiency was found in 47.6% (n=10), diabetes insipidus in 47.6% (n=10), TSH deficiency in 14.3% (n=3). One patient had low gonadotrophins. One case of growth hormone deficiency was noted. Three patients had multiple deficiencies.
Conclusions: Only a minority of patients are assessed for hypopituitarism following TBI. Assessments that do occur have inadequate scope. In those assessed, the prevalence of hypopituitarism is high, with multiple hormones affected in some. This may reflect selection bias, if testing is based on clinical suspicion. Given this high prevalence, we recommend the development of screening tools for early detection of pituitary dysfunction following TBI. The relevance of early testing will be discussed.
Methods: Data were retrospectively collected on 104 patients admitted to the Wessex Neurological Centre with TBI over 1-year. An electronic TBI database and patient notes were reviewed for endocrinological tests performed, results and deficiencies identified.
Results: Only 37.5% (n=39) of patients were assessed for any form of pituitary dysfunction. On average, these assessments only covered 1.9 of 6 clinically relevant pituitary hormones per patient. Of patients tested, 53.8% (n=21) were found to have pituitary dysfunction. ACTH deficiency was found in 47.6% (n=10), diabetes insipidus in 47.6% (n=10), TSH deficiency in 14.3% (n=3). One patient had low gonadotrophins. One case of growth hormone deficiency was noted. Three patients had multiple deficiencies.
Conclusions: Only a minority of patients are assessed for hypopituitarism following TBI. Assessments that do occur have inadequate scope. In those assessed, the prevalence of hypopituitarism is high, with multiple hormones affected in some. This may reflect selection bias, if testing is based on clinical suspicion. Given this high prevalence, we recommend the development of screening tools for early detection of pituitary dysfunction following TBI. The relevance of early testing will be discussed.
| Original language | English |
|---|---|
| Pages (from-to) | S53 |
| Number of pages | 1 |
| Journal | International journal of surgery (London, England) |
| Volume | 12 |
| Issue number | supplement 3 |
| DOIs | |
| Publication status | Published - 30 Nov 2014 |
