Relationship of thyroid function to post-traumatic S-100b serum levels in survivors of severe head injury: preliminary results.
OBJECTIVE
To assess thyroid function abnormalities in survivors of severe head trauma and to examine their relationship with indices of brain injury severity.


METHODS
Prospective study.


METHODS
General intensive care unit (ICU) in a university hospital.


METHODS
Twenty-two (21 men) head-injured patients, with a median age of 25.5 years at the time of injury, were investigated. Severity of brain trauma was assessed by Glasgow Coma Scale (GCS) score, Marshall Computerized Tomographic Classification, intracranial pressure levels and serum S-100b concentrations measured over a 6-day period.


METHODS
Thyroid function testing was performed 1 year after ICU discharge and included the measurement of free thyroxine, triiodothyronine and thyrotropin.


RESULTS
On admission to the ICU, GCS ranged from 3 to 8. Peak S-100b was 1.49 microg/l (range: 0.37-5.26 microg/l). Median triiodothyronine and thyrotropin were 123 ng/dl and 1.60 microIU/ml, respectively. Free thyroxine was 1.08+/-0.22 ng/dl (range: 0.7-1.5 ng/dl). Overall, 7 of the 22 patients (32%) had thyroid dysfunction. Four patients had central hypothyroidism and three patients had subclinical hypothyroidism. Peak S-100b correlated negatively with free thyroxine (r=-0.47, p=0.02). There were no correlations between other brain injury severity indices and thyroid hormone levels.


CONCLUSIONS
A significant subset of brain injury patients presents with changes in thyroid function 1 year after ICU discharge; these depend upon biochemical serum markers of head trauma severity.
Department of Critical Care Medicine, Evangelismos Hospital , Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece. idimo@otenet.gr.|, 2 Pesmazoglou Street, 14 561, Kifissia, Athens, Greece. idimo@otenet.gr.
Ioanna
I
Dimopoulou
Department of Endocrinology, Metabolism and Diabetes, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece.
Stylianos
S
Tsagarakis
Department of Neurosurgery, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece.
Stefanos
S
Korfias
Department of Critical Care Medicine, Evangelismos Hospital , Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece.
Dimitrios
D
Zervakis
Department of Critical Care Medicine, Evangelismos Hospital , Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece.
Evangelia
E
Douka
Department of Endocrinology, Metabolism and Diabetes, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece.
Nikolaos
N
Thalassinos
Department of Neurosurgery, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece.
Damianos E
DE
Sakas
Department of Critical Care Medicine, Evangelismos Hospital , Medical School, National and Kapodistrian University of Athens, 45-47 Ipsilandou Street, 106 75, Athens, Greece.
Charis
C
Roussos
D000293:Adolescent; D000328:Adult; D006259:Craniocerebral Trauma / Q000097:blood / Q000503:physiopathology*; D015600:Glasgow Coma Scale; D006801:Humans; D008875:Middle Aged; D009414:Nerve Growth Factors; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D017741:Survivors; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000502:physiology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood
D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine