Nelson Vergel
Founder, ExcelMale.com
J Head Trauma Rehabil. 2015 Sep 10.
Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction.
Barton DJ1, Kumar RG, McCullough EH, Galang G, Arenth PM, Berga SL, Wagner AK.
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 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 to 16 weeks post injury 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.
Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction.
Barton DJ1, Kumar RG, McCullough EH, Galang G, Arenth PM, Berga SL, Wagner AK.
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 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 to 16 weeks post injury 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.
