title: Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction.
abstract: 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.
  
  
  
  Level 1 trauma center at a university hospital.
  
  
  
  Consecutive sample of men with severe TBI between 2004 and 2009.
  
  
  
  Prospective cohort study.
  
  
  
  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.
  
  
  
  We recruited 78 men; median (interquartile range) age was 28.5 (22-42) years. Thirty-four patients (44%) had PHH during the first year postinjury. 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 postinjury yielded a sensitivity of 79% and specificity of 100%.
  
  
  
  PHH status in men predicts poor outcome after severe TBI, and PHH can accurately be predicted at 12 to 16 weeks.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (Messrs Barton and Kumar, Ms McCullough, and Drs Galang, Arenth, and Wagner); Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, North Carolina (Dr Berga); and Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Wagner).
authors.forename: David J
authors.initials: DJ
authors.lastname: Barton
authors.forename: Raj G
authors.initials: RG
authors.lastname: Kumar
authors.forename: Emily H
authors.initials: EH
authors.lastname: McCullough
authors.forename: Gary
authors.initials: G
authors.lastname: Galang
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Arenth
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Berga
authors.forename: Amy K
authors.initials: AK
authors.lastname: Wagner
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000503:physiopathology; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis; D006801:Humans; D007006:Hypogonadism / Q000150:complications*; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D013739:Testosterone / Q000097:blood; D055815:Young Adult
chemical_list: D013739:Testosterone