Ghaith S Aljboor, Aoun Tulemat, Ali Ridha Al-Saedi, Mugurel Petrinel Radoi, Corneliu Toader, Toma Marius Papacocea
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Pooled estimates with 95% confidence intervals (CIs) were calculated using random-effects models in the R statistical software. Subgroup analyses were performed based on duration post-TBI (< 3 months, 3-6 months, 6-12 months, > 12 months) to explore temporal variations. Heterogeneity was assessed using the I^2 statistic. A total of 52 studies were included in the meta-analysis, encompassing 7367 participants. The pooled estimate for the prevalence of any pituitary axis dysfunction post-TBI was 33% (95% CI [28%; 37%]). Subgroup analysis by duration revealed varying prevalence rates: < 3 months (40%, 95% CI [27%; 53%]), 3-6 months (31%, 95% CI [15%; 47%]), 6-12 months (26%, 95% CI [19%; 33%]), and > 12 months (32%, 95% CI [26%; 38%]). Prevalence of multiple axes affection was 7% (95% CI [6%; 9%]), with varying rates across durations. Specific axes affection varied: Growth Hormone (GH) deficiency was 18% (95% CI [14%; 21%]), adrenocorticotropic hormone (ACTH) deficiency was 10% (95% CI [8%; 13%]), pituitary-gonadal axis hormones deficiency was 16% (95% CI [12%; 19%]), and thyroid-stimulating hormone (TSH) deficiency was 6% (95% CI [5%; 7%]). This meta-analysis highlights a significant prevalence of pituitary axis dysfunction following TBI, with temporal variations observed across different post-injury durations. The findings underscore the importance of tailored clinical management strategies based on the duration and type of dysfunction. Further research addressing potential contributing factors is warranted to enhance understanding and management of these conditions.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"47 1","pages":"841"},"PeriodicalIF":2.5000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554839/pdf/","citationCount":"0","resultStr":"{\"title\":\"Acute and chronic hypopituitarism following traumatic brain injury: a systematic review and meta-analysis.\",\"authors\":\"Ghaith S Aljboor, Aoun Tulemat, Ali Ridha Al-Saedi, Mugurel Petrinel Radoi, Corneliu Toader, Toma Marius Papacocea\",\"doi\":\"10.1007/s10143-024-03088-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Traumatic brain injury (TBI) is associated with various endocrine abnormalities, including pituitary axis dysfunction. 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引用次数: 0
摘要
创伤性脑损伤(TBI)与包括垂体轴功能障碍在内的各种内分泌异常有关。了解这些功能障碍的患病率和时间模式对于有效的临床治疗至关重要。本研究旨在系统回顾文献并进行荟萃分析,以确定创伤性脑损伤后垂体轴功能障碍的患病率,评估不同伤后持续时间的时间模式,并确定潜在的致病因素。我们对 2000 年 1 月 1 日至 2024 年 3 月 31 日期间的多个电子数据库进行了全面检索。纳入了报告创伤后垂体轴功能障碍患病率的研究。使用 R 统计软件中的随机效应模型计算了汇总估计值和 95% 置信区间 (CI)。根据创伤后持续时间(12 个月)进行分组分析,以探讨时间上的变化。异质性采用 I^2 统计量进行评估。共有 52 项研究被纳入荟萃分析,涉及 7367 名参与者。TBI后垂体轴功能障碍的总体估计值为33%(95% CI [28%; 37%])。按持续时间进行的分组分析显示了不同的患病率:12个月(32%,95% CI [26%; 38%])。多轴损伤的患病率为 7% (95% CI [6%; 9%]),不同病程的患病率各不相同。具体的轴突症状各不相同:生长激素(GH)缺乏率为 18% (95% CI [14%; 21%]),促肾上腺皮质激素(ACTH)缺乏率为 10% (95% CI [8%; 13%]),垂体-性腺轴激素缺乏率为 16% (95% CI [12%; 19%]),促甲状腺激素(TSH)缺乏率为 6% (95% CI [5%; 7%])。这项荟萃分析强调了创伤性脑损伤后垂体轴功能障碍的显著发病率,在不同的伤后持续时间内观察到了时间上的变化。这些发现强调了根据功能障碍的持续时间和类型制定有针对性的临床管理策略的重要性。有必要针对潜在的致病因素开展进一步研究,以加强对这些病症的了解和管理。
Acute and chronic hypopituitarism following traumatic brain injury: a systematic review and meta-analysis.
Traumatic brain injury (TBI) is associated with various endocrine abnormalities, including pituitary axis dysfunction. Understanding the prevalence and temporal patterns of these dysfunctions is crucial for effective clinical management. This study aimed to systematically review the literature and conduct a meta-analysis to determine the prevalence of pituitary axis dysfunction following TBI, assess temporal patterns across different post-injury durations, and identify potential contributing factors. A comprehensive search was conducted across multiple electronic databases between 1st of January 2000 until 31st March 2024. Studies reporting the prevalence of pituitary axis dysfunction post-TBI were included. Pooled estimates with 95% confidence intervals (CIs) were calculated using random-effects models in the R statistical software. Subgroup analyses were performed based on duration post-TBI (< 3 months, 3-6 months, 6-12 months, > 12 months) to explore temporal variations. Heterogeneity was assessed using the I^2 statistic. A total of 52 studies were included in the meta-analysis, encompassing 7367 participants. The pooled estimate for the prevalence of any pituitary axis dysfunction post-TBI was 33% (95% CI [28%; 37%]). Subgroup analysis by duration revealed varying prevalence rates: < 3 months (40%, 95% CI [27%; 53%]), 3-6 months (31%, 95% CI [15%; 47%]), 6-12 months (26%, 95% CI [19%; 33%]), and > 12 months (32%, 95% CI [26%; 38%]). Prevalence of multiple axes affection was 7% (95% CI [6%; 9%]), with varying rates across durations. Specific axes affection varied: Growth Hormone (GH) deficiency was 18% (95% CI [14%; 21%]), adrenocorticotropic hormone (ACTH) deficiency was 10% (95% CI [8%; 13%]), pituitary-gonadal axis hormones deficiency was 16% (95% CI [12%; 19%]), and thyroid-stimulating hormone (TSH) deficiency was 6% (95% CI [5%; 7%]). This meta-analysis highlights a significant prevalence of pituitary axis dysfunction following TBI, with temporal variations observed across different post-injury durations. The findings underscore the importance of tailored clinical management strategies based on the duration and type of dysfunction. Further research addressing potential contributing factors is warranted to enhance understanding and management of these conditions.
期刊介绍:
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.