Thyroid function in the subacute phase of traumatic brain injury: a potential predictor of post-traumatic neurological and functional outcomes.
Brain
/ diagnostic imaging
Brain Injuries, Traumatic
/ complications
Epilepsy, Post-Traumatic
/ blood
Female
Humans
Italy
/ epidemiology
Male
Middle Aged
Neuroimaging
/ methods
Neurologic Examination
/ methods
Predictive Value of Tests
Prognosis
Recovery of Function
Risk Assessment
/ methods
Thyroid Function Tests
/ methods
Thyroid Gland
/ metabolism
Trauma Severity Indices
Triiodothyronine
/ blood
Epilepsy
Outcome
Thyroid
Traumatic brain injury
Journal
Journal of endocrinological investigation
ISSN: 1720-8386
Titre abrégé: J Endocrinol Invest
Pays: Italy
ID NLM: 7806594
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
21
03
2021
accepted:
29
07
2021
pubmed:
6
8
2021
medline:
16
3
2022
entrez:
5
8
2021
Statut:
ppublish
Résumé
That thyroid hormones exert pleiotropic effects and have a contributory role in triggering seizures in patients with traumatic brain injury (TBI) can be hypothesized. We aimed at investigating thyroid function tests as prognostic factors of the development of seizures and of functional outcome in TBI. This retrospective study enrolled 243 adult patients with a diagnosis of mild-to-severe TBI, consecutively admitted to our rehabilitation unit for a 6-month neurorehabilitation program. Data on occurrence of seizures, brain imaging, injury characteristics, associated neurosurgical procedures, neurologic and functional assessments, and death during hospitalization were collected at baseline, during the workup and on discharge. Thyroid function tests (serum TSH, fT4, and fT3 levels) were performed upon admission to neurorehabilitation. Serum fT3 levels were positively associated with an increased risk of late post-traumatic seizures (LPTS) in post-TBI patients independent of age, sex and TBI severity (OR = 1.85, CI 95% 1.22-2.61, p < 0.01). Measured at admission, fT3 values higher than 2.76 pg/mL discriminated patients with late post-traumatic seizures from those without, with a sensitivity of 74.2% and a specificity of 60.9%. Independently from the presence of post-traumatic epilepsy and TBI severity, increasing TSH levels and decreasing fT3 levels were associated with worse neurological and functional outcome, as well as with higher risk of mortality within 6 months from the TBI event. Serum fT3 levels assessed in the subacute phase post-TBI are associated with neurological and functional outcome as well as with the risk of seizure occurrence. Further studies are needed to investigate the mechanisms underlying these associations.
Identifiants
pubmed: 34351610
doi: 10.1007/s40618-021-01656-8
pii: 10.1007/s40618-021-01656-8
pmc: PMC8783844
doi:
Substances chimiques
Triiodothyronine
06LU7C9H1V
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
379-389Informations de copyright
© 2021. The Author(s).
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