Abstract
Background Neurological and neurosurgical early rehabilitation (NNER) is a specialized treatment option for patients with severe neurological disorders. The present study investigated whether thyroid hormone levels on admission have an impact on the outcome of NNER patients. Method The study included 500 NNER patients who were admitted to the BDH-Clinic Hessisch Oldendorf between 2009 and 2010. Data such as age, sex, diagnoses, comorbidities, Glasgow Coma Scale score, length of stay, and thyroid hormone levels (obtained as part of clinical routine care) were analyzed retrospectively. Improvement in the Early Rehabilitation Barthel Index (ERBI) at the end of the NNER treatment was defined as outcome parameter. Results Most patients made functional progress during treatment, as reflected in significant enhancements of the ERBI. Approximately half of the patients were transferred to further rehabilitation treatment. Young age, early onset of NNER treatment, low functional impairment on admission, and, in particular, low total T3 levels were independently associated with a good outcome. Conclusion Age, severity of disease, and time between injury and admission are known to predict outcome. The present study confirms the influence of these general factors. In addition, an association between thyroid hormones and functional outcome was demonstrated for NNER patients.
Highlights
Acute critical events induce complex multisystem reactions, which affect endocrine functions [1]
Results from Zetterling and colleagues indicate that the association between low T3 levels and poor short-term functional outcome in stroke and TBI patients can be found after intracerebral hemorrhages [7]
The thyroid stimulating hormone (TSH) level was negatively correlated with the free T4 level, but not with the total T3 level
Summary
Acute critical events induce complex multisystem reactions, which affect endocrine functions [1]. For patients with acute traumatic brain injuries, thyroid hormone deficiencies (e.g., low levels of T3, T4, and TSH) are reported in 2 to 15 percent of cases [5]. Results from Zetterling and colleagues indicate that the association between low T3 levels and poor short-term functional outcome in stroke and TBI patients can be found after intracerebral hemorrhages [7]. The present study investigated whether thyroid hormone levels on admission have an impact on the outcome of NNER patients. The study included 500 NNER patients who were admitted to the BDH-Clinic Hessisch Oldendorf between 2009 and 2010 Data such as age, sex, diagnoses, comorbidities, Glasgow Coma Scale score, length of stay, and thyroid hormone levels (obtained as part of clinical routine care) were analyzed retrospectively. An association between thyroid hormones and functional outcome was demonstrated for NNER patients
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