ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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ORIJINAL ARAŞTIRMA

Travmatik Beyin Hasarı Olan Hastalarda Travma Şiddetine Göre Fonksiyonel, Bilişsel ve Emosyonel Sonuçların ve Hipofiz Hormon Düzeylerinin Değerlendirilmesi
Evaluation of Functional, Cognitive and Emotional Outcomes and Pituitary Hormones According to Trauma Severity in Patients with Traumatic Brain Injury
Received Date : 02 Jun 2021
Accepted Date : 11 Aug 2021
Available Online : 26 Aug 2021
Doi: 10.31609/jpmrs.2021-84770 - Makale Dili: TR
J PMR Sci. 2022;25(2):150-7
ÖZET
Amaç: Kronik dönem orta veya ağır travmatik beyin hasarı (TBH) olan erişkin hastalarda ön hipofiz hormon düzeylerini, fonksiyonel, bilişsel ve emosyonel sonuçları karşılaştırmak, bu parametrelerin travma şiddeti ile ilişkisini belirlemek hedeflenmiştir. Gereç ve Yöntemler: Kesitsel olarak planlanan bu çalışmaya en az 6 aydır TBH’li olan 53 hasta dâhil edildi. Travma şiddeti ilk 24 saat içinde kaydedilen Glaskow Koma Skalası (GKS) skoruna göre belirlendi, hastalar orta (n=20) ve ağır TBH (n=33) olarak 2 gruba ayrıldı. Fonksiyonel Bağımsızlık Ölçeği (FBÖ), Mini Mental Durum Testi (MMDT), Ranchos Los Amigos Kognitif Fonksiyon Skalası (RLAS), Beck Depresyon Ölçeği (BDÖ) ve Beck Anksiyete Ölçeği (BAÖ) değerlendirmeler için kullanıldı. Ayrıca tüm hastaların adrenokortikotropik hormon, prolaktin, folikül uyarıcı hormon, luteinize edici hormon, tiroid uyarıcı hormon, insülin benzeri büyüme faktörü-1 ve büyüme hormon bazal seviyeleri ölçüldü. Bulgular: Orta ve ağır TBH olan hastalar arasında FBÖ, MMDT, BDÖ ve BAÖ değerleri bakımından anlamlı farklılık vardı ancak ön hipofiz hormon bazal düzeyleri farklılık göstermedi. GKS ile FBÖ ve MMDT arasında pozitif ilişki, BDÖ ve BAÖ arasında negatif ilişki görülürken ön hipofiz hormon düzeyleri ile ilişki saptanmadı. Sonuç: Kronik TBH olan hastalarda travmanın şiddeti arttıkça günlük yaşam aktivitelerinde bağımlılık, depresif duygudurum, anksiyete ve bilişsel işlevlerde bozulma artmaktadır. Bu nedenle, GKS skorunun kaydedilmesi, sonraki rehabilitasyon sürecinde, özellikle klinik sonuçların belirlenmesi açısından değerlidir.
ABSTRACT
Objective: To compare the anterior pituitary hormone levels, functional, cognitive, and emotional outcomes in adult patients with chronic period moderate or severe traumatic brain injury (TBI) and to determine the relationship between these parameters and the severity of trauma. Material and Methods: Fifty-three patients with TBI were included in this cross-sectional study. Trauma severity was determined according to the Glasgow Coma Scale (GCS) score recorded within the first 24 hours, and the patients were divided into 2 groups as moderate (n=20) and severe TBI (n=33). Functional Independence Measure (FIM), Mini Mental State Test (MMST), Ranchos Los Amigos Cognitive Function Scale (RLAS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used for evaluations. Basal levels of adrenocorticotropic hormone, prolactin, follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone, insulin-like growth factor-1 and growth hormone were measured in all patients. Results: There was a significant difference between patients with moderate and severe TBI in terms of FIM, MMST, BDI and BAI values but no difference was found in anterior pituitary hormone basal levels. There was a positive relationship between GCS score and FIM and MMST, and a negative relationship between BDI and BAI while no relationship was noted between GCS score and anterior pituitary basal hormone levels. Conclusion: In patients with chronic TBI, dependence in daily living activities, depressive mood, anxiety and deterioration in cognitive functions increase as the severity of trauma increases. Therefore, assigning the GCS score is valuable in the subsequent rehabilitation process, especially in terms of determining clinical results.
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