Risk factors for corticosteroid insufficiency during the sub-acute phase of acute traumatic brain injury

作     者：Xin Chen Yan Chai Shao-Bo Wang Jia-Chong Wang Shu-Yuan Yue Rong-Cai Jiang Jian-Ning Zhang Xin Chen;Yan Chai;Shao-Bo Wang;Jia-Chong Wang;Shu-Yuan Yue;Rong-Cai Jiang;Jian-Ning Zhang

作者机构：Department of NeurosurgeryGeneral Hospital of Tianjin Medical UniversityTianjinChina Tianjin Neurological InstituteKey Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous SystemMinistry of EducationTianjin Key Laboratory of InjuriesVariations and Regeneration of Nervous SystemTianjinChina Department of NeurosurgeryOrdos Central HospitalOrdosInnerMongolia Autonomous RegionChina Department of NeurosurgeryAffiliated Haikou Hospital of Xiangya Medical CollegeCentral South UniversityChangshaHunan ProvinceChina 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2020年第15卷第7期

页      面：1259-1265页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：supported by the National Natural Science Foundation of China,No.81671902(to XC) 81501704(to YC) the Project of Tianjin Applied Basic and Cutting-edge Technological Research of China,No.17JCYBJC25200(to XC) 15JCQNJC44900(to YC) Tianjin Health Care Elite Prominent Young Doctor Development Program(to XC) the Young and Middle-aged Backbone Innovative Talent Program(to XC) 

主　　题：brain herniation corticosteroid critical illness-related corticosteroid dexamethasone suppression test diffuse axonal injury gastrointestinal bleeding hemorrhagic cerebral contusions hospital-acquired pneumonia insufficiency prognosis traumatic brain injury 

摘      要：Hypothalamic-pituitary-adrenal axis dysfunction may lead to the occurrence of critical illness-related corticosteroid *** illness-related corticosteroid insufficiency can easily occur after traumatic brain injury,but few studies have examined this occurrence.A multicenter,prospective,cohort study was performed to evaluate the function of the hypothalamic-pituitary-adrenal axis and the incidence of critical illness-related corticosteroid insufficiency during the sub-acute phase of traumatic brain *** hundred and forty patients with acute traumatic brain injury were enrolled from the neurosurgical departments of three tertiary-level hospitals in China,and the critical illness-related corticosteroid insufficiency incidence,critical-illness-related corticosteroid insufficiency-related risk factors,complications,and 28-day mortality among these patients was *** illness-related corticosteroid insufficiency was diagnosed in patients with plasma total cortisol levels less than 10μg/dL(275.9 nM)on post-injury day 4 or when serum cortisol was insufficiently suppressed(less than 50%)during a dexamethasone suppression test on post-injury day *** results demonstrated that critical illness-related corticosteroid insufficiency occurred during the sub-acute phase of traumatic brain injury in 5.6%of patients with mild injury,22.5%of patients with moderate injury,and 52.2%of patients with severe *** brain injury-induced critical illness-related corticosteroid insufficiency was strongly correlated to injury severity during the sub-acute stage of traumatic brain *** brain injury patients with critical illness-related corticosteroid insufficiency frequently presented with hemorrhagic cerebral contusions,diffuse axonal injury,brain herniation,and *** in the incidence of hospital-acquired pneumonia,gastrointestinal bleeding,and 28-day mortality were observed between patients with and without critical i