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Relationship of thyroid function to post-traumatic S-100b serum levels in survivors of severe head injury: preliminary results

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Abstract

Objective

To assess thyroid function abnormalities in survivors of severe head trauma and to examine their relationship with indices of brain injury severity.

Design

Prospective study.

Setting

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

Patients and participants

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.

Interventions

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

Measurements and results

On admission to the ICU, GCS ranged from 3 to 8. Peak S-100b was 1.49 µg/l (range: 0.37–5.26 µg/l). Median triiodothyronine and thyrotropin were 123 ng/dl and 1.60 μIU/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.

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Author notes

  1. Ioanna Dimopoulou

    Present address: , 2 Pesmazoglou Street, 14 561, Kifissia, Athens, Greece

Authors and Affiliations

  1. Department of Critical Care Medicine, Evangelismos Hospital , Medical School, National and Kapodistrian University of Athens, 45–47 Ipsilandou Street, 106 75, Athens, Greece

    Ioanna Dimopoulou, Dimitrios Zervakis, Evangelia Douka & Charis Roussos

  2. 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 Tsagarakis & Nikolaos Thalassinos

  3. Department of Neurosurgery, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, 45–47 Ipsilandou Street, 106 75, Athens, Greece

    Stefanos Korfias & Damianos E. Sakas

Authors
  1. Ioanna Dimopoulou
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  2. Stylianos Tsagarakis
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  3. Stefanos Korfias
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  4. Dimitrios Zervakis
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  5. Evangelia Douka
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  6. Nikolaos Thalassinos
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  7. Damianos E. Sakas
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  8. Charis Roussos
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Corresponding author

Correspondence to Ioanna Dimopoulou.

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Dimopoulou, I., Tsagarakis, S., Korfias, S. et al. Relationship of thyroid function to post-traumatic S-100b serum levels in survivors of severe head injury: preliminary results. Intensive Care Med 30, 298–301 (2004). https://doi.org/10.1007/s00134-003-2058-7

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  • DOI: https://doi.org/10.1007/s00134-003-2058-7

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