Harshita Debbarma, Anil Kumar, Tarique Jamil Hasan
{"title":"中重度脑外伤成人垂体功能障碍的发病率:一项前瞻性研究。","authors":"Harshita Debbarma, Anil Kumar, Tarique Jamil Hasan","doi":"10.36106/ijsr/5807019","DOIUrl":null,"url":null,"abstract":"Background: Traumatic brain injury (TBI) is a growing public health problem worldwide and is a leading cause of death and disability. Hormonal\nalterations leading to post-traumatic pituitary dysfunction (PTPD) usually become apparent in the rst hours or days after TBI.In this study, we\nfocused on the prevalence of anterior and posterior pituitary hormonal alterations in the acute and chronic post-TBI period in adults. Material &\nMethod: The study design is a prospective study done in RIMS, Ranchi from March 2021-March 2023. Patients of TBI who were fullling our\ninclusion criteria were randomly selected. All pituitary hormonal assessmentwas done both in the acute phase (within 14 days of post-TBI) and\nchronic phase (1 month, 3 months & 6 months post-TBI). The outcome of patients was analyzed by Modied Rankin Scale. Result: Mean ± SD\n(range) age at the time of TBI in the 80 patients (62 Male:18 Female) was 40.24 ± 16.77 (18-65) years with moderate TBI (GCS 9-12) in 59\n(73.75%) and severe TBI (GCS < 8) in 29 (36.25%). RTA was the most frequent cause, occurring in 83.75% of patientsDuring acute phase 16\npatients (25%) are found having AI with serum cortisol level 179 ± 98.25nmol/L (< -2 SD). 10 out of 80 patients were found to have GHD\n(IGF-1 <-2SD) at the end of 3 months & 6 months post-TBI.Presence of DI was seen in 10/80 (12.5% of patients) which is identied around 13 ±\n4.52 days. Hypothyroidism was seen in 5% and hypogonadism in 2.5% of study population. Conclusion: Despite the publication of several case\nseries, the true incidence of PTHPremains a matter of considerable debate with divergent rates reported between centers. Acoordinated approach\nby neurosurgeons, endocrinologists, and the neurorehabilitation unit is fully recommended to provide adequate care to these patients.","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"37 4","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PREVALENCE OF PITUITARY DYSFUNCTION IN MODERATE-TO-SEVERE TRAUMATIC BRAIN INJURY IN ADULTS: A PROSPECTIVE STUDY.\",\"authors\":\"Harshita Debbarma, Anil Kumar, Tarique Jamil Hasan\",\"doi\":\"10.36106/ijsr/5807019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Traumatic brain injury (TBI) is a growing public health problem worldwide and is a leading cause of death and disability. Hormonal\\nalterations leading to post-traumatic pituitary dysfunction (PTPD) usually become apparent in the rst hours or days after TBI.In this study, we\\nfocused on the prevalence of anterior and posterior pituitary hormonal alterations in the acute and chronic post-TBI period in adults. Material &\\nMethod: The study design is a prospective study done in RIMS, Ranchi from March 2021-March 2023. Patients of TBI who were fullling our\\ninclusion criteria were randomly selected. All pituitary hormonal assessmentwas done both in the acute phase (within 14 days of post-TBI) and\\nchronic phase (1 month, 3 months & 6 months post-TBI). The outcome of patients was analyzed by Modied Rankin Scale. Result: Mean ± SD\\n(range) age at the time of TBI in the 80 patients (62 Male:18 Female) was 40.24 ± 16.77 (18-65) years with moderate TBI (GCS 9-12) in 59\\n(73.75%) and severe TBI (GCS < 8) in 29 (36.25%). RTA was the most frequent cause, occurring in 83.75% of patientsDuring acute phase 16\\npatients (25%) are found having AI with serum cortisol level 179 ± 98.25nmol/L (< -2 SD). 10 out of 80 patients were found to have GHD\\n(IGF-1 <-2SD) at the end of 3 months & 6 months post-TBI.Presence of DI was seen in 10/80 (12.5% of patients) which is identied around 13 ±\\n4.52 days. Hypothyroidism was seen in 5% and hypogonadism in 2.5% of study population. Conclusion: Despite the publication of several case\\nseries, the true incidence of PTHPremains a matter of considerable debate with divergent rates reported between centers. Acoordinated approach\\nby neurosurgeons, endocrinologists, and the neurorehabilitation unit is fully recommended to provide adequate care to these patients.\",\"PeriodicalId\":14358,\"journal\":{\"name\":\"International journal of scientific research\",\"volume\":\"37 4\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of scientific research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36106/ijsr/5807019\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of scientific research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36106/ijsr/5807019","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
PREVALENCE OF PITUITARY DYSFUNCTION IN MODERATE-TO-SEVERE TRAUMATIC BRAIN INJURY IN ADULTS: A PROSPECTIVE STUDY.
Background: Traumatic brain injury (TBI) is a growing public health problem worldwide and is a leading cause of death and disability. Hormonal
alterations leading to post-traumatic pituitary dysfunction (PTPD) usually become apparent in the rst hours or days after TBI.In this study, we
focused on the prevalence of anterior and posterior pituitary hormonal alterations in the acute and chronic post-TBI period in adults. Material &
Method: The study design is a prospective study done in RIMS, Ranchi from March 2021-March 2023. Patients of TBI who were fullling our
inclusion criteria were randomly selected. All pituitary hormonal assessmentwas done both in the acute phase (within 14 days of post-TBI) and
chronic phase (1 month, 3 months & 6 months post-TBI). The outcome of patients was analyzed by Modied Rankin Scale. Result: Mean ± SD
(range) age at the time of TBI in the 80 patients (62 Male:18 Female) was 40.24 ± 16.77 (18-65) years with moderate TBI (GCS 9-12) in 59
(73.75%) and severe TBI (GCS < 8) in 29 (36.25%). RTA was the most frequent cause, occurring in 83.75% of patientsDuring acute phase 16
patients (25%) are found having AI with serum cortisol level 179 ± 98.25nmol/L (< -2 SD). 10 out of 80 patients were found to have GHD
(IGF-1 <-2SD) at the end of 3 months & 6 months post-TBI.Presence of DI was seen in 10/80 (12.5% of patients) which is identied around 13 ±
4.52 days. Hypothyroidism was seen in 5% and hypogonadism in 2.5% of study population. Conclusion: Despite the publication of several case
series, the true incidence of PTHPremains a matter of considerable debate with divergent rates reported between centers. Acoordinated approach
by neurosurgeons, endocrinologists, and the neurorehabilitation unit is fully recommended to provide adequate care to these patients.