Research Reports - Weight gain after childhood traumatic brain injury: a matter of concern
Dev Med Child Neurol. 2012 Apr 24. doi: 10.1111/j.1469-8749.2012.04291.x. [Epub
ahead of print]
Jourdan C, Brugel D, Hubeaux K, Toure H, Laurent-Vannier A, Chevignard M.
Aim The aim of the study was to assess weight changes after traumatic brain
injury (TBI) in children and the factors influencing them. Method We conducted a
longitudinal observational study of children with TBI of mixed severity who were
consecutively admitted to one rehabilitation department (39 children; 23 males,
16 females; median age 8y 7mo; 25th to 75th centiles 3y 7mo-11y 6mo). Weight and
height before TBI were obtained from the children's records and were measured
monthly for 1 year after TBI. Body mass index (BMI) and BMI z-scores were
calculated, and pre-TBI values were compared with the final values using paired
tests. Linear mixed-effect interaction models were used to assess the effect of
various factors on z-score evolution. Results Z-score curves revealed early
weight loss followed by a rapid increase in weight. The mean BMI gain over the
period under study was 0.9kg/m² (p < 0.001) and the mean z-score gain was 0.4
(p = 0.006). Six children had become overweight by the time of final assessment.
Factors associated with a greater rate of increase in the post-TBI z-score were
mobility restriction, male sex, and older age. Global pre- to post-TBI weight
gain was significantly higher in males (z-score 0.7). Pituitary hormonal testing
was available for 17 children at 3 months and for 27 at 1 year. Growth hormone
deficiency was detected in one child. Interpretation Weight gain of children
during the first year after TBI was rapid and excessive. Male sex was a risk
factor for excessive weight gain.