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Euthyroid sick syndrome in head injury patients compared with Glasgow Coma and Outcome Scales
R Palugniok1, A A Kochańska-Dziurowicz
14th Specialist District Hospital, Bytom, Poland.
Background:
Evaluation of the role of euthyroid sick syndrome and pituitary gland hormonal changes and the prognosis of patient mortality after severe brain injury.
Methods:
The research was conducted on 65 patients with isolated severe brain injury. Blood samples were obtained as soon as possible after the injury and on the 1st, 2nd, 3rd, 5th and 7th day after the injury. Blood concentrations of T(3), rT(3), T(4), FT(4), TSH, and PRL were estimated. The patients' state of health was evaluated in the sixth hour after the injury, using Glasgow Coma Scale, and after 180 days, using the Glasgow Outcome Scale. Multidirectional correlation was sought between the concentrations of the estimated hormones and the score obtained in the Glasgow Coma Scale and Glasgow Outcome Scale.
Results:
Cluster analysis showed that concentrations of the hormones in the patients who died are grouped in different clusters from those in the patients who survived. This proves that hormonal patterns are different in these groups. Statistically significant lower T(3) concentrations were observed on the 3rd day in comparison with the 0 day. Cumulative proportion surviving was lower for the OP group in comparison with the NOP group and amounted to 0.57.
Conclusions:
In all patients covered by the research euthyroid sick syndrome was diagnosed. T(3) concentration on the 3rd day after the injury together with the evaluation in Glasgow Coma Scale allows for more precise prognosis.
