Projects

PIT-TBI Prospective Multicenter Pilot Cohort Study: Pituitary Disorders in Patients with Moderate and Severe TBI

Traumatic brain injury (TBI) is a major cause of mortality and morbidity. Many survivors suffer from concentration deficit, fatigue, depression and low resistance to effort. These symptoms affect their quality of life, their functional level and have a significant impact on primary health care resources utilisation. Several of these symptoms could be attributable to hormonal deficits. In fact, pituitary disorders are an often neglected side effect of TBI. Nonetheless, studies published to date have not adequately evaluated the clinical impact of pituitary disorders nor their risk factors in the context of TBI.

The main objectives of this study will be to evaluate the feasibility of conducting a large multicenter prospective observational cohort study. We will evaluate protocol adherence and we will estimate the recruitment rate at each participating center.

This study, conducted in 4 trauma centers across Canada, is a critical step in an innovative research program on pituitary disorders. This study will have a significant impact on health care in Canada. Indeed, if we demonstrate that pituitary disorders affect the neurological prognostic, functional status, quality of life or depressive symptoms, our results will justify the implementation of a systematic screening strategy to detect these disorders in patients suffering from TBI. These results would then also justify the conduct of randomised clinical trials to evaluate the relevance of initiating hormonal replacement therapy. On the other hand, if we show that pituitary disorders and prognostics are not linked, our results will prevent unnecessary, costly screening and prevent potentially harmful hormonal replacement therapy in this vulnerable population.

Funding

This study is funded with a grant from the Canadian Institutes of Health Research and the Fonds de Recherche du Québec – Santé.

co-Investigators

• Patrick Archambault
• Francis Bernard
• Amélie Boutin
• Debrah Cook
• Claudia Gagnon
• Donald Griesdale
• Margaret Herridge
• Geneviève Houde
• François Lamontagne
• Lauralyn McIntyre
• Karene Menon
• Lynne Moore
• Giusseppe Pagliarello
• Pascal Perron
• François Rousseasu
• Damon Scales
• Alexis Turgeon

Centers

• CHU de Québec – Université Laval (Hôpital de l’Enfant-Jésus) (Quebec city, Quebec)
• Hôpital du Sacré-Coeur de Montréal (Montréal, Quebec)
• Centre Hospitalier Universitaire de Sherbrooke (Sherbrooke, Quebec)
• The Ottawa Hospital (Ottawa, Ontario)