Evaluation Of Acute Neuroendocrine Dysfunction Among Patients With Traumatic Brain Injury In Kenyatta National Hospital

Résumé

Backgroung: Traumatic brain injury (TBI) is a global health issue often resulting in post-traumatic hypopituitarism (PTHP). PTHP diagnosis is challenging due to symptom overlap with post-traumatic stress disorder. Hypopituitarism correlates with adverse outcomes, including cognitive impairment and reduced quality of life. Objective: To determine the prevalence of hypopituitarism among patients with traumatic brain injury in Kenyatta National Hospital. Methods:A prospective cohort study was conducted in the neurosurgical wards and Intensive Care Unit of Kenyatta National Hospital. Patients with severe TBI (Glasgow Coma Scale <8) admitted within 24 hours were included. Data collected included demographic information, injury severity, complications, and outcomes. Follow-ups were made at 24- and 72-hours post-admission until discharge or one-month post-admission. Results: High prevalence of adrenal insufficiency (60.4%) and hypothyroidism (17.0%) Adrenal insufficiency significantly associated with poorer 3-month Glasgow Outcome   Scale   scores   (χ²(3)   =   9.545,   p   =   0.023)  Sepsis significantly associated with hypothyroidism (χ²(1) = 4.633, p = 0.031) No significant associations between neuroendocrine dysfunction and age, pre-morbid conditions, or cause of injury. Conclusion: Neuroendocrine dysfunction, particularly adrenal insufficiency and hypothyroidism, is prevalent among TBI patients and impacts recovery outcomes. Routine endocrine assessments and multidisciplinary care are crucial for improving TBI management. Future research should focuson larger, longitudinal studies to further understand and address neuroendocrine dysfunction in TBI patients.