• Stepani Bendel, Timo Koivisto, Olli-Pekka Ryynänen, Esko Ruokonen, Jarkko Romppanen, Vesa Kiviniemi, and Ari Uusaro.
• Department of Intensive Care, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. Stepani.Bendel@kuh.fi
• Crit Care. 2010 Jan 1; 14 (2): R75.

IntroductionNeuroendocrine deficiencies may affect recovery after aneurysmal subarachnoid hemorrhage (aSAH). Insulin like growth factor-I (IGF-I) regulates neuronal growth and apoptosis in ischemic stroke. Our study was designed to a) characterize the behavior of serum IGF-I and growth hormone (GH) in the acute and late phases after aSAH reflecting possible pituitary gland function and b) evaluate the association between IGF-I and morbidity assessed by Glasgow outcome scale (GOS) and health related quality of life (HRQoL) in patients with aSAH.MethodsIn this prospective cohort study, patients with aSAH (n = 30) were compared to patients who underwent elective aneurysm surgery (n = 16). Serum GH and IGF-I concentrations were measured daily for five (controls) or seven (aSAH) days and at three months. GOS and 15d HRQoL was measured at three months. A mixed models method was used for testing between the groups. For factors possibly affecting HRQoL in aSAH patients, we constructed a Bayesian predicting model using a P-course Bayesian classifier.ResultsThe mean IGF-I concentrations for days one to five were 8.1 +/- 3.5 nmol/l in patients with aSAH and 11.2 +/- 3.1 in the control group (P = 0.01). No corresponding difference was found at three months. Serum GH concentrations were similar in both patient groups. Severity of the aSAH did not affect serum IGF-I concentrations. Patients with GOS ConclusionsIGF-I concentrations are low during acute aSAH, which may have an impact on morbidity.Trial RegistrationClinicalTrials.gov Identifier NCT00614887.

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