Limited Adherence to Growth Hormone Replacement in Patients with Traumatic Brain Injury

BACKGROUND: Growth hormone deficiency is a recognized consequence of traumatic brain injury. The aim of this study was to determine adherence to human growth hormone therapy among patients with traumatic brain injury compared with patients with hypothalamic or pituitary disease. METHODS: A retrospective chart review of patients with traumatic brain injury referred for growth hormone stimulation testing since December 2013. Within the same electronic medical record, patients who were started on human growth hormone for aetiologies other than traumatic brain injury were reviewed. Adherence to therapy at 1-year followup was compared. RESULTS: Of the patients with traumatic brain injury, 12/23 (52%) returned for follow-up at 1 year to continue human growth hormone treatment, whereas 11/23 (48%) did not return at 1 year. Amongst the patients with non-traumatic brain injury: 25/29 (86%) continued human growth hormone treatment, vs 4/29 (14%) who did not return. A higher proportion of patients with non-traumatic brain injury continued human growth hormone treatment; x(2) (1, n = 52)p = 7.238, p = 0.007. CONCLUSION: There may be differences in the patient-perceived benefits of human growth hormone between these patient populations. However, it is important to consider the potential influences of cognitive and psychosocial dysfunction that can occur in patients with brain injuries.