Journal of Rehabilitation Medicine 51-4inkOmslag | Page 34

268
A. Tölli et al.
Table III. Relations between hormone function during the first year
after traumatic brain injury (TBI) and aneurysmal subarachnoid
haemorrhage (aSAH), and Rancho Los Amigos Cognitive Scale-
Revised (RLAS-R) results at 12 months post-event
RLAS-R
Hormonal axis
Thyroid n  = 78
Low levels n  = 20
Normal levels n  = 40
High levels n  = 18
Adrenal n  = 64
Low levels n  = 9
Normal levels n  = 24
High levels n  = 31
Somatotrophic n  = 82
Low levels n  = 10
Normal levels n  = 58
High levels n  = 14
Gonadal n  = 80
Low levels n  = 30
Normal levels n  = 50
Prolactin n  = 81
Low levels n  = 3
Normal levels n  = 69
High levels n  = 9
Mean (SD) Median Range
LL vs NL
p-value HL vs NL
p-value
8.2 (1.8)
8.4 (2.2)
7.3 (1.8) 8.5
9
7 4–10
3–10
5–10 p  = 0.381 p  = 0.026*
7.6 (2.1)
8.3 (1.7)
8.1 (2.0) 7
9
9 4–10
5–10
3–10 p  = 0.392 p  = 0.714
8.6 (1.9)
8.3 (2.8)
5.9 (2.6) 10
9
5 6–10
5–10
3–10 p  = 0.707 p  = 0.006*
7.4 (2.2) 7.5 3–10
8.3 (1.9) 9 3–10
7.0 (3.0)
8.1 (2.0)
6.8 (1.8) 7
9
6 4–10
3–10
5–10
p  = 0.025*
***p  < 0.001, ** p  < 0.01, *p  < 0.05.
LL: low levels; NL: normal levels; HL: high levels.
months after the event with GCS (b = 0.14, p = 0.020,
CI: 0.02–0.26), but not with age (b = –0.03, p = 0.113),
or with sex (b = 0.87, p = 0.058), or with high T4
(b = –0.84, p = 0.133) or with low T4 (b = –0.17,
p = 0.738). Thyroid level, age, GCS and sex explained
16.6% of the variance of the RLAS-R scores (adjusted
R 2  = 0.166).
Somatotrophic axis
RLAS-R scores were significantly lower (p = 0.006)
in the subgroup with high IGF-I levels in comparison
with those with normal IGF-I levels. Patients with
high IGF-I levels were significantly (p = 0.019) older
(mean 60.1 years (SD 9.7) than patients with normal
IGF-I levels (mean 50.2 years (SD14.8). Comparisons
of the other baseline variables showed no significant
differences in any subgroup.
Multiple linear regression analysis demonstrated
significant relationships between RLAS-R score
at 12 months after the event with GCS (b = 0.13,
p = 0.019, CI: 0.02–0.24), and high IGF-I (b = –1.78,
p = 0.002, CI: –2.87––0.70), but not with age (b = –0.03,
p = 0.074), or with sex (b = 0.62, p = 0.144), or with low
IGF-I (b = 0.29, p = 0.639). IGF-I level, age, GCS and
sex explained 24.3% of the variance on the RLAS-R
scores (adjusted R 2  = 0.243).
Prolactin
RLAS-R scores were significantly lower (p = 0.025) in
the subgroup with high prolactin levels in comparison
www.medicaljournals.se/jrm
Adrenal and gonadal axis
RLAS scores did not differ between subgroups with
different cortisol levels (p = 0.674) and gonadal levels
(p = 0.182).
p  = 0.072
p  = 0.519
with those with normal prolactin levels. Comparisons
of the other baseline variables showed no significant
differences in any subgroup.
Multiple linear regression analysis demonstrated
significant relationships between RLAS-R score at 12
months after the event with age (b = –0.04, p = 0.013,
CI: –0.07––0.01), GCS (b = 0.12, p = 0.037, CI:
0.01–0.23) and high prolactin (b = –1.42, p = 0.034, CI:
–2.73––0.11), but not with sex (b = 0.54, p = 0.236), or
with low prolactin (b = –1.20, p = 0.285). Prolactin le-
vel, age, GCS and sex explained 18.2% of the variance
of the RLAS-R scores (adjusted R 2  = 0.182).
Multiple axes
Multiple linear regression analysis demonstrated no
significant relationships between RLAS-R score at 12
months after the event and low (b = –0.18, p = 0.678) or
high hormone levels (b = –0.12, p = 0.783).
Glasgow Outcome Scale extended version and
pituitary dysfunction
Data are displayed in Table IV. At 12 months, 37%
(34/91) of patients had a bad outcome and 63% (57/91)
had a good outcome.
Table IV. Relations between hormone function during the first year
after traumatic brain injury (TBI) and aneurysmal subarachnoid
haemorrhage (aSAH), and Glasgow Outcome Scale Extended
(GOSE) results at 12 months post-event
GOSE
Hormonal axis
Thyroid n  = 78
Low levels n  = 20
Normal levels n  = 40
High levels n  = 18
Adrenal n  = 64
Low levels n  = 9
Normal levels n  = 24
High levels n  = 31
Somatotrophic n  = 82
Low levels n  = 10
Normal levels n  = 58
High levels n  = 14
Gonadal n  = 80
Low levels n  = 30
Normal levels n  = 50
Prolactin n  = 81
Low levels n  = 3
Normal levels n  = 69
High levels n  = 9
Mean (SD) Median Range
LL vs NL HL vs NL
p-value p-value
5.5 (1.6)
5.6 (1.7)
4.4 (1.6) 6
6
4 3–8
3–8
3–8 p  = 0.503 p  = 0.011*
4.7 (1.9)
5.7 (1.5)
5.6 (1.5) 4
6
6 3–8
3–8
3–8 p  = 0.154 p  = 0.979
5.4 (1.7)
5.5 (1.7)
4.2 (1.6) 5
6
3 3–7
3–8
3–7 4.6 (1.7)
5.6 (1.6) 4
6 3–8
3–8 p  = 0.011*
4.3 (2.3)
5.4 (1.7)
4.0 (1.5) 3
6
3 3–7
3–8
3–7 p  = 0.355 p  = 0.022*
***p  < 0.001, ** p  < 0.01, *p  < 0.05
LL: low levels; NL: normal levels; HL: high levels.
p  = 0.736
p  = 0.053