Prevalence of hypopituitarism and quality of life in survivors of post‐traumatic brain injury

Abstract

Abstract Background Hypopituitarism is a recognized sequela of traumatic brain injury (TBI) and may worsen the quality of life (QoL) in survivors. Aims To assess the prevalence of post‐traumatic hypopituitarism (PTHP) and growth hormone deficiency (GHD), and determine their correlation with QoL. Methods Survivors of moderate to severe TBI were recruited from two Algerian centres. At 3 and 12 months, pituitary function was evaluated using insulin tolerance test (ITT), QoL by growth hormone deficiency in adults’ questionnaire (QoL‐AGHDA), and 36‐item short‐form (SF‐36) health survey. Results Of 133 (M: 128; F: 5) patients aged 18‐65 years, PTHP and GHD were present at 3 and 12 months in 59 (44.4%) and 23 (17.29%), 41/116 (35.3%) and 18 (15.5%). Thirteen patients with GHD at 3 months tested normally at 12 months, while 9 had become GHD at 12 months. At 3 and 12 months, peak cortisol was < 500 nmol/L) in 39 (29.3%) and 29 (25%) patients, but <300 nmol/L in only five and seven. Prevalence for gonadotrophin deficiency was 6.8/8.6%, hypo‐ and hyperprolactinaemia 6.8/3.8% and 5.2/8.6%, and thyrotrophin deficiency 1.5/0.9%. Mean scores for QoL‐AGHDA were higher in patients with PTHP at 3 and 12 months: 7.07 vs 3.62 (P = .001) and in patients with GHD at 12 months: 8.72 vs 4.09 (P = .015). Mean SF‐36 scores were significantly lower for PTHP at 3 months. Conclusion Prevalence of PTHP and GHD changes with time. AGHDA measures QoL in GHD more specifically than SF‐36. Full pituitary evaluation and QoL‐AGHDA 12 months after TBI are recommended.

Keywords

• growth hormone deficiency
• post‐traumatic hypopituitarism
• QoL‐AGHDA
• quality of life