ArticleCritical care (London, England)2008
Pituitary-adrenal function in patients with acute subarachnoid haemorrhage: a prospective cohort study.
Article in Critical care (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00614887 (Hypothalamo-, Pituitary-, Adrenal Axis Dysfunction in Subarachnoid Hemorrhage), which is not on this map. Cited by 17 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Hypothalamo-, Pituitary-, Adrenal Axis Dysfunction in Subarachnoid Hemorrhage
Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Prevalence of pituitary dysfunction after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.BMC neurology · 2023Pooled it
- Pooled it
- Cortisol levels and the severity and outcomes of acute stroke: a systematic review.Journal of neurology · 2014Pooled it
- Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference.Neurocritical care · 2011Guideline
- The Unique Relationship between Neuro-Critical Care and Critical Illness-Related Corticosteroid Insufficiency : Implications for Neurosurgeons in Neuro-Critical Care.Journal of Korean Neurosurgical Society · 2023Article
- Adrenocorticotropic hormone and β-endorphin concentration as a prognostic factor in patients with subarachnoid hemorrhage due to aneurysmal rupture.Journal of cerebrovascular and endovascular neurosurgery · 2022Article
- Observational
- Review
- Article
- Hypopituitarism after subarachnoid haemorrhage, do we know enough?BMC neurology · 2014Review
- Three years prospective investigation of pituitary functions following subarachnoid haemorrhage.Pituitary · 2013Article
- Circadian variation in ictus of aneurysmal subarachnoid hemorrhage.Neurocritical care · 2012Article
- Endocrine function following acute SAH.Neurocritical care · 2011Review
- SAH pituitary adrenal dysfunction.Neurocritical care · 2011Review
- The association between cortisol dynamics and the course of aneurysmal subarachnoid hemorrhage.Asian journal of neurosurgery · 2011Article
- Insulin like growth factor-I in acute subarachnoid hemorrhage: a prospective cohort study.Critical care (London, England) · 2010Article
- Hypothalamo-pituitary-adrenal axis activity after intracranial catastrophies: what is enough?Critical care (London, England) · 2009Review
Corrections and comments
- Commented on by
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSubarachnoid haemorrhage (SAH) may damage the hypothalamo-pituitary-adrenal gland (HPA) axis and disturb cortisol metabolism. There are no available data that relates to the response of the HPA axis in the acute phase of SAH. We aimed to characterise the behavior of serum adrenocorticotropic hormone (ACTH), total cortisol, stimulated total cortisol and free cortisol concentrations in acute aneurysmal SAH.
methodsA prospective cohort study was conducted of patients with acute aneurysmal SAH (n = 30) admitted to a tertiary university hospital. Patients admitted for elective aneurysmal surgery (n = 16) served as the control group. An ACTH stimulation test was performed twice during the first week and at three months. The main outcome measure was description of the ACTH-cortisol response by calculating serum free cortisol and measuring total cortisol and ACTH concentrations. A mixed models method was used for testing between the groups, allowing heterogeneity between the groups.
resultsPatients with SAH had higher initial serum total cortisol (mean +/- SD; 793 +/- 312 nmol/L) and free cortisol concentrations (83 +/- 55 nmol/L) than control patients (535 +/- 193 nmol/L, p = 0.001 and 33 +/- 18 nmol/L, p < 0.001, respectively). Thereafter, there were no differences in this respect. Serum free and total cortisol concentrations correlated but were unaffected by the severity of SAH. ACTH concentrations were comparable between SAH and control groups. Patients with Hunt-Hess grades IV to V had higher ACTH concentrations at day one (10.7 +/- 7.1 pmol/l/L) and day five (8.2 +/- 7.7 pmol/L) than patients with grade I-III (day one: 3.8 +/- 2.0 pmol/L, p = 0.002; day five: 4.7 +/- 1.8 pmol/L, p = 0.04).
conclusionsCalculation of serum free cortisol concentration was not helpful in identifying patients with potential hypocortisolism. SAH severity did not affect cortisol concentrations, possibly indicating relative pituitary-adrenal insufficiency in patients with more severe bleeding.
trial registrationClinicalTrials.gov Identifier NCT00614887.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.