Association between growth hormone deficiency and quality of life after traumatic brain injury: a case–control study

Objective Traumatic brain injury (TBI) is a leading cause of long-term disability. Post-traumatic hypopituitarism, particularly growth hormone deficiency (GHD), is an increasingly recognized yet frequently underdiagnosed sequela of moderate-to-severe TBI (msTBI). This study aimed to determine whether untreated GHD is associated with reduced quality of life (QOL) in adults with chronic msTBI.Design Prospective case-control study of 138 adults with chronic msTBI: 69 with GHD and 69 matched controls without GHD. QOL was measured using the Quality of Life after Brain Injury questionnaire. GHD was diagnosed by glucagon stimulation testing at least 1 year after injury.Results Demographic characteristics were similar between groups. Cases with GHD reported lower QOL in the Emotions domain than controls (21.4 vs 24.7, corrected p = 0.021), including worse energy, self-esteem, self-perception, and future outlook. The overall Feelings domain was not significantly different in matched analysis, but anxious feelings and sadness/depression were worse in the GHD group. In multivariable mixed-effects regression, absence of GHD was associated with better overall QOL (β = 0.46, p = 0.0016), and model-estimated QOL differed significantly in the Emotion and Feelings domains.Conclusions Untreated GHD after chronic msTBI is associated with poorer emotional well-being and lower overall QOL, supporting consideration of endocrine evaluation in this population.