David J Barton1, Raj G Kumar, Emily H McCullough, Gary Galang, Patricia M Arenth, Sarah L Berga, Amy K Wagner. 1. Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (Messrs Barton and Kumar, Ms McCullough, and Drs Galang, Arenth, and Wagner); Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina (Dr Berga); and Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Wagner).
Abstract
OBJECTIVE: To (1) examine relationships between persistent hypogonadotropic hypogonadism (PHH) and long-term outcomes after severe traumatic brain injury (TBI); and (2) determine whether subacute testosterone levels can predict PHH. SETTING: Level 1 trauma center at a university hospital. PARTICIPANTS: Consecutive sample of men with severe TBI between 2004 and 2009. DESIGN: Prospective cohort study. MAIN MEASURES: 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% or more of samples met criteria for hypogonadotropic hypogonadism. At 6 and 12 months postinjury, we assessed global outcome, disability, functional cognition, depression, and quality of life. RESULTS: We recruited 78 men; median (interquartile range) age was 28.5 (22-42) years. Thirty-four patients (44%) had PHH during the first year postinjury. 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 to 16 weeks postinjury yielded a sensitivity of 79% and specificity of 100%. CONCLUSION: PHH status in men predicts poor outcome after severe TBI, and PHH can accurately be predicted at 12 to 16 weeks.
OBJECTIVE: To (1) examine relationships between persistent hypogonadotropic hypogonadism (PHH) and long-term outcomes after severe traumatic brain injury (TBI); and (2) determine whether subacute testosterone levels can predict PHH. SETTING: Level 1 trauma center at a university hospital. PARTICIPANTS: Consecutive sample of men with severe TBI between 2004 and 2009. DESIGN: Prospective cohort study. MAIN MEASURES: 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% or more of samples met criteria for hypogonadotropic hypogonadism. At 6 and 12 months postinjury, we assessed global outcome, disability, functional cognition, depression, and quality of life. RESULTS: We recruited 78 men; median (interquartile range) age was 28.5 (22-42) years. Thirty-four patients (44%) had PHH during the first year postinjury. 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 to 16 weeks postinjury yielded a sensitivity of 79% and specificity of 100%. CONCLUSION:PHH status in men predicts poor outcome after severe TBI, and PHH can accurately be predicted at 12 to 16 weeks.
Authors: Abdelouahid Tajar; Gianni Forti; Terence W O'Neill; David M Lee; Alan J Silman; Joseph D Finn; György Bartfai; Steven Boonen; Felipe F Casanueva; Aleksander Giwercman; Thang S Han; Krzysztof Kula; Fernand Labrie; Michael E J Lean; Neil Pendleton; Margus Punab; Dirk Vanderschueren; Ilpo T Huhtaniemi; Frederick C W Wu Journal: J Clin Endocrinol Metab Date: 2010-02-19 Impact factor: 5.958
Authors: Michelle D Failla; John M Myrga; Joseph H Ricker; C Edward Dixon; Yvette P Conley; Amy K Wagner Journal: J Head Trauma Rehabil Date: 2015 Nov-Dec Impact factor: 2.710
Authors: Daniel F Kelly; David L McArthur; Harvey Levin; Shana Swimmer; Joshua R Dusick; Pejman Cohan; Christina Wang; Ronald Swerdloff Journal: J Neurotrauma Date: 2006-06 Impact factor: 5.269
Authors: V Popovic; S Pekic; D Pavlovic; N Maric; M Jasovic-Gasic; B Djurovic; M Medic Stojanoska; V Zivkovic; M Stojanovic; M Doknic; N Milic; M Djurovic; C Dieguez; F F Casanueva Journal: J Endocrinol Invest Date: 2004-12 Impact factor: 4.256
Authors: Andrea Kleindienst; Georg Brabant; Christoph Bock; Christiane Maser-Gluth; Michael Buchfelder Journal: J Neurotrauma Date: 2009-09 Impact factor: 5.269
Authors: Steven M Petak; Howard R Nankin; Richard F Spark; Ronald S Swerdloff; Luis J Rodriguez-Rigau Journal: Endocr Pract Date: 2002 Nov-Dec Impact factor: 3.443
Authors: Patricia B de la Tremblaye; Darik A O'Neil; Megan J LaPorte; Jeffrey P Cheng; Joshua A Beitchman; Theresa Currier Thomas; Corina O Bondi; Anthony E Kline Journal: Neurosci Biobehav Rev Date: 2017-05-30 Impact factor: 8.989
Authors: Sushupta M Vijapur; Zhihui Yang; David J Barton; Leah Vaughan; Nabil Awan; Raj G Kumar; Byung-Mo Oh; Sarah L Berga; Kevin K Wang; Amy K Wagner Journal: J Neurotrauma Date: 2020-04-13 Impact factor: 5.269
Authors: Rastafa I Geddes; Kentaro Hayashi; Quinn Bongers; Marlyse Wehber; Icelle M Anderson; Alex D Jansen; Chase Nier; Emily Fares; Gabrielle Farquhar; Amita Kapoor; Toni E Ziegler; Sivan VadakkadathMeethal; Ian M Bird; Craig S Atwood Journal: PLoS One Date: 2017-01-26 Impact factor: 3.240
Authors: Rastafa I Geddes; Amita Kapoor; Kentaro Hayashi; Ryan Rauh; Marlyse Wehber; Quinn Bongers; Alex D Jansen; Icelle M Anderson; Gabrielle Farquhar; Sivan Vadakkadath-Meethal; Toni E Ziegler; Craig S Atwood Journal: Endocrinol Diabetes Metab Date: 2021-03-18