Trauma and thyroid-stimulating hormone abnormalities in pediatric patients

Abstract

Background

There is limited literature on trauma and endocrine abnormalities in the pediatric trauma setting.

Aim

We studied demographic, medical history, injury experience, and mortality factors to determine their association with abnormal thyroid-stimulating hormone in pediatric trauma patients.

Methods

The 414 pediatric trauma patients were from those seen at an emergency department. The primary outcome variable was abnormal thyroid-stimulating hormone. Secondary outcome variables were abnormal high and abnormal low thyroid-stimulating hormone. Predictor variables were demographics (age, sex, race/ethnicity, body mass index), medical history (thyroid disease, diabetes mellitus, autoimmune disease, psychiatric disease), injury experience (injury cause, injury severity score ≥ 15, moderate/severe traumatic brain injury, length of stay), and mortality (mortality, survival probability). Multivariate logistic regression analyses were conducted.

Results

There were 8.0% (n = 33) with any abnormal thyroid-stimulating hormone value. In the analysis for abnormal thyroid-stimulating hormone, females (odds ratio:4.95, 95% confidence interval: 2.01, 12.21, p < 0.01) and traumatic brain injury (odds ratio: 8.11, 95% confidence interval: 2.51, 26.16, p < 0.001) were each significantly associated with increased odds. In the analysis for abnormal high thyroid-stimulating hormone (odds ratio: 3.75, 95% confidence interval: 1.37, 10.24, p < 0.05), traumatic brain injury (odds ratio: 11.59, 95% confidence interval: 3.45, 38.97, p < 0.001), and mortality (odds ratio: 35.59, 95% confidence interval: 1.40, 906.57, p < 0.05) were each significantly associated with increased odds. In the analysis for abnormal low thyroid-stimulating hormone, only females (odds ratio: 11.10, 95% confidence interval: 1.26, 97.60, p < 0.05) were significantly associated with increased odds.

Conclusion

In conclusion, females and traumatic brain injury have increased odds for abnormal thyroid-stimulating hormone. Mortality has increased odds for abnormal high thyroid-stimulating hormone. We suggest that clinicians in the pediatric trauma setting carefully monitor females and traumatic brain injury patients with abnormal thyroid-stimulating hormone.

Keywords

Thyroid-stimulating hormone thyrotropin trauma pediatric brain injury traumatic

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