TY - JOUR
T1 - Pituitary dysfunction after aneurysmal subarachnoid haemorrhage
T2 - course and clinical predictors the HIPS study
AU - Khajeh, L.
AU - Blijdorp, K.
AU - Heijenbrok-Kal, M. H.
AU - Sneekes, E. M.
AU - van den Berg-Emons, H. J. G.
AU - van der Lely, A. J.
AU - Dippel, D. W. J.
AU - Neggers, S. J. C. M. M.
AU - Ribbers, G. M.
AU - van Kooten, F.
N1 - Funding:
This study was financially supported by an unrestricted grant from Pfizer
and by the Dutch Brain Foundation
PY - 2015/8
Y1 - 2015/8
N2 - Objective We describe the occurrence and course of anterior pituitary dysfunction (PD) after aneurysmal subarachnoid haemorrhage (SAH), and identify clinical determinants for PD in patients with recent SAH.Methods We prospectively collected demographic and clinical parameters of consecutive survivors of SAH and measured fasting state endocrine function at baseline, 6 and 14 months. We included dynamic tests for growth-hormone function. We used logistic regression analysis to compare demographic and clinical characteristics of patients with SAH with and without PD.Results 84 patients with a mean age of 55.8 (11.9) were included. Thirty-three patients (39%) had PD in one or more axes at baseline, 22(26%) after 6 months and 6 (7%) after 14 months. Gonadotropin deficiency in 29 (34%) patients and growth hormone deficiency (GHD) in 26 (31%) patients were the most common deficiencies. PD persisted until 14 months in 6 (8%) patients: GHD in 5(6%) patients and gonadotropin deficiency in 4 (5%). Occurrence of a SAH-related complication was associated with PD at baseline (OR 2.6, CI 2.2 to 3.0). Hydrocephalus was an independent predictor of PD 6 months after SAH (OR 3.3 CI 2.7 to 3.8). PD was associated with a lower score on health-related quality of life at baseline (p=0.06), but not at 6 and 14 months.Conclusions Almost 40% of SAH survivors have PD. In a small but substantial proportion of patients GHD or gonadotropin deficiency persists over time. Hydrocephalus is independently associated with PD 6 months after SAH.
AB - Objective We describe the occurrence and course of anterior pituitary dysfunction (PD) after aneurysmal subarachnoid haemorrhage (SAH), and identify clinical determinants for PD in patients with recent SAH.Methods We prospectively collected demographic and clinical parameters of consecutive survivors of SAH and measured fasting state endocrine function at baseline, 6 and 14 months. We included dynamic tests for growth-hormone function. We used logistic regression analysis to compare demographic and clinical characteristics of patients with SAH with and without PD.Results 84 patients with a mean age of 55.8 (11.9) were included. Thirty-three patients (39%) had PD in one or more axes at baseline, 22(26%) after 6 months and 6 (7%) after 14 months. Gonadotropin deficiency in 29 (34%) patients and growth hormone deficiency (GHD) in 26 (31%) patients were the most common deficiencies. PD persisted until 14 months in 6 (8%) patients: GHD in 5(6%) patients and gonadotropin deficiency in 4 (5%). Occurrence of a SAH-related complication was associated with PD at baseline (OR 2.6, CI 2.2 to 3.0). Hydrocephalus was an independent predictor of PD 6 months after SAH (OR 3.3 CI 2.7 to 3.8). PD was associated with a lower score on health-related quality of life at baseline (p=0.06), but not at 6 and 14 months.Conclusions Almost 40% of SAH survivors have PD. In a small but substantial proportion of patients GHD or gonadotropin deficiency persists over time. Hydrocephalus is independently associated with PD 6 months after SAH.
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=eur_pure&SrcAuth=WosAPI&KeyUT=WOS:000357884300014&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1136/jnnp-2014-307897
DO - 10.1136/jnnp-2014-307897
M3 - Article
C2 - 25378238
SN - 0022-3050
VL - 86
SP - 905
EP - 910
JO - Journal of Neurology Neurosurgery and Psychiatry
JF - Journal of Neurology Neurosurgery and Psychiatry
IS - 8
ER -