2067 Correlation Between Neuro-Endocrine Profile and Functional Recovery After Diffuse Axonal Injury

INTRODUCTION: Diffuse axonal injury (DAI) is a type of traumatic brain injury characterized by widespread axonal damage in the white matter of the brain, without evidence of lesions on computed tomography. Approximately one-third of DAI patients exhibit hypopituitarism. There are no consolidated studies assessing the impacts of serum hormones on the prognosis of patients with DAI. METHODS: We enrolled 112 patients (median age 26.0 years, IQR:21.0-35.0) with DAI. Serum samples were obtained upon admission to neurorehabilitation (on average, 382 ± 94 days after the trauma) for analysis of ACTH, DHEAS, cortisol, GH, prolactin, IGF-1, IGFBP3, TSH, T3, T4, fT4, FSH, LH, total testosterone, free testosterone and SHBG. Functional recovery was assessed using the Glasgow Outcome Scale (GOS) 5 years after the trauma (Favorable:4-5, Unfavorable:1-3). Logistic regression analyses were conducted to examine the association between variables and outcomes. RESULTS: In the univariable analysis, higher T3 levels were found to correlate with a favorable functional outcome based on the Glasgow Outcome Scale (OR: 1.031 for every 1 ng/dL increase;[95%CI] 1.009 - 1.055; p= 0.007). The serum levels of cortisol, GH, prolactin, IGF-1, TSH, fT4, FSH, LH, testosterone and SHBG showed no impact on the functional outcome in 5 years (p>0.05). In a multivariable analysis adjusting for age, sex, and severity of trauma, a notable positive correlation persisted between serum T3 levels and the outcome (p=0.033). The mean T3 levels measured 114.0 ± 24.8 ng/dL in the favorable outcome group and 128.7 ± 21.8 ng/dL in the unfavorable outcome group. CONCLUSIONS: In patients with DAI, higher T3 levels upon admission to neurorehabilitation were associated with a favorable functional outcome assessed by GOS in 5 years. No other serum hormone levels significantly impacted the functional outcome of patients.