The effects of craniocerebral and extracranial trauma on the changes in serum testosterone and estradiol in the early stage and their clinical significance.

BACKGROUND

This study aimed to examine the correlation between the alterations in serum sex hormones testosterone (T) and estradiol (E2) in the early stages after craniocerebral and extracranial injuries, to assess the Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) score in patients with multiple injuries, and to investigate the significance of the posttrauma changes in ISS and GCS as well as their ratio.

METHODS

The serum levels of T and E(2) in 95 patients with multiple injuries in the early stages after trauma (within 24 hours) were determined by radioimmune double-antibody method. All the patients were classified by ISS, and among them, those complicated with craniocerebral injury were classified by GCS. The serum sex hormone levels and their ratio in the patients with trauma were compared with those in the control group consisting of 15 healthy persons.

RESULTS

In patients with multiple injuries, in the early stage after injury, the serum T level decreased in proportion with the severity of the trauma, whereas the E2 level increased. There was a significant difference in T, E(2), and the ratio of E(2) and T in the severely traumatic group (ISS > 25) as compared with the other groups (p < 0.01). Among the groups complicated with craniocerebral injury that were classified by GCS, there were significant differences in the groups of 5 ≥ GCS ≥ 3 and 8 ≥ GCS > 5, compared with the control group (p < 0.01).

CONCLUSION

The alterations in the serum sex hormones T and E2 levels and their ratio is correlated with the severity of trauma and craniocerebral injury and, thus probably, could serve as an indicator for the evaluation of the trauma severity and possibly in prognosis.

LEVEL OF EVIDENCE

Prognostic study, level III.