Growth monitoring following traumatic brain injury

• Published in: Archives of disease in childhood Vol. 94; no. 9; pp. 699 - 701
• Main Authors: Moon, R J, Wilson, P, Kirkham, F J, Davies, J H
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.09.2009; BMJ Publishing Group; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Adolescent; Age; Biological and medical sciences; Body Height; Body Weight; Brain; Brain injuries; Brain Injuries - physiopathology; Brain Injuries - therapy; Brain research; Child; Child, Preschool; Children; Children & youth; Clinics; Coma; Company growth; Complications and side effects; Demographic aspects; Documentation; Female; Follow-Up Studies; General aspects; Growth; Growth (Physiology); Growth Disorders - physiopathology; Humans; Hypopituitarism; Hypopituitarism - diagnosis; Hypopituitarism - etiology; Hypopituitarism - physiopathology; Infant; Injuries; Injuries of the nervous system and the skull. Diseases due to physical agents; Intensive Care Units, Pediatric; Male; Medical sciences; Miscellaneous; Neurology; Neurosurgery; Outpatient Clinics, Hospital - standards; Patient outcomes; Patients; Pediatric injuries; Pediatrics; Pituitary Gland - physiopathology; Prevention and actions; Primary care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk factors; Standard deviation; Studies; Traumas. Diseases due to physical agents; Traumatic brain injury; Trends; England; United Kingdom; Human; Pediatrics; Nervous system diseases; Surveillance; Growth; Head trauma; Child; Monitoring; Public health
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.2008.145235

Hypopituitarism is an important consequence of traumatic brain injury (TBI). Growth monitoring can be used as an indicator of pituitary function in children. A retrospective audit of case notes of 123 children who required intensive care unit admission with TBI found that only 71 (33%) of 212 attendances in 38 of 85 children followed up had documented height and weight measurements. Children were reviewed in 11 different specialty clinics, which showed a wide variation in the frequency of growth monitoring. Serial growth measurements were available for only 22 patients (17%), which showed a reduction in height standard deviation scores (0.17 (SD 0.33), p = 0.017) over a mean follow-up period of 25.2 (SD 21.6) months. In conclusion, growth monitoring following TBI was poorly performed in this cohort, highlighting the need for a co-ordinated approach by primary and secondary care and all departments in tertiary centres involved in the follow-up of children with TBI.