Table 1.
Previous studies showing gonadotrophic axis hormones profile during acute phase of severe TBI in male.
| Reference | Time-course after TBI | Results in male | Clinical correlations and significance for mortality and morbidity |
|---|---|---|---|
| Agha et al. (14) | 7 to 20 days (median 12) | Low testosterone levels in 79% of patients | Positive correlation between testosterone and TBI and GCS (r = 0.32, p = 0.048); Association between testosterone and prognosis were not analyzed |
| Cernak et al. (9) | Up to 7 days | Testosterone decrease in 2 days after TBI | Association between hormone levels and TBI severity and prognosis were not analyzed |
| Dalwadi et al. (15) | 24 h | Low testosterone in 63.5% of patients | Correlation between testosterone and GCS did not reach significance No association between LH and testosterone and mortality Imbalances in the distribution of other predictors were not described Small sample size of severe TBI patients |
| Hohl et al. (10) | Up to 48 h | Low LH in 36.8% of patients in the 1st day and 41.8% in the 2nd day Low testosterone in 36.5% of patients in the 1st day and 73.1% in the 2nd day |
Trend for independent association between normal or elevated LH mortality (p = 0.08) Distribution of other predictive variables and hormones were not controlled The possibility of type II error related to the small sample size should be considered |
| Kleindienst et al. (21) | Admission Day 1 and 7 | In comparison to admission, the mean LH and testosterone levels decrease on day 3 and 7 after TBI | Association between injury severity and low testosterone and LH levels on day 3 Higher LH levels associated with number of lesions on the CT scan Association between testosterone and prognosis were not analyzed Small sample size of patients with severe TBI |
| Klose et al. (16) | Up to 12 days | Lower LH levels and testosterone | Correlation between low testosterone and TBI severity Wide range of time course between TBI and blood sampling for hormone analysis Association between hormones and prognosis were not analyzed Small sample size of patients with severe TBI |
| Hari Kumar et al. (17) | 24 h | Low testosterone in 37.5% of patients | No association between LH or testosterone and GCS Association between hormones and prognosis were not analyzed Small sample size of patients with severe TBI |
| Olivecrona et al. (18) | Days 1 and 4 | Low testosterone in 82.1 and 100% of patients at the 1st and 4th day after the TBI respectively Low LH in 55.2% and 58.6% of patients in the 1st and 4th days after the TBI respectively |
Higher LH on day 1 (but not day 4) in patients with unfavorable outcome (morbidity and mortality) 3 months after TBI Regression models combining LH levels and ICPmax showed significant association with prognosis and ICPmax still was the main predicting factor (AUC for this model was not shown) Prognostic models including other predictors (GCS, pupils, sub-arachnoid hemorrhage) and LH levels were not analyzed by the authors |
| Tanriverdi et al. (19) | 24 h | Significant lower testosterone levels, but not LH, in patients with severe TBI | Positive correlation between testosterone and GCS Association between testosterone and prognosis were not analyzed Small sample size of patients with severe TBI |
| Wagner et al. (21) | Day 1 to 9 | Low LH in 50% of patients Low testosterone in 91% of patients LH and testosterone decline were seen in non-head injured extracranial trauma |
LH or testosterone during acute phase of injury was not associated with the prognosis (GOS) 6 months after the TBI |
TBI, traumatic brain injury; GCS, Glasgow coma scale; GOS, Glasgow outcome scale; ISS, injury severity score; Marshal grade, Marshal Computed Tomography Classification; ICPmax, maximal intracranial pressure.