Virginia Via Research Day Book 2026

Medical Student Research Clinical

04 COMPARATIVE ANALYSIS OF QUALITY OF LIFE IN TRAUMATIC BRAIN INJURY PATIENTS WITH AND WITHOUT GROWTH HORMONE DEFICIENCY

Mason Nelson, OMS-III; Ramzi Badra, OMS-III; Brooke Scardina, OMS-III; Varun Mishra, MS-IV; Taylor P. van Doren, PhD; Melissa Martinez, NP; Justin Weppner, DO Corresponding author: jlweppner@carilionclinic.org

VCOM-Virginia, Blacksburg, Virginia Virginia Tech-Carilion School of Medicine, Roanoke, Virginia High Point University, High Point, North Carolina Carilion Clinic Brain Injury Center, Roanoke, Virginia Context: Traumatic brain injury (TBI) is a major cause of long-term disability which impacts quality of life (QOL). Growth hormone deficiency (GHD) is common after moderate-to-severe TBI (msTBI) and may contribute to persistent impairments. Individuals recovering from msTBI report symptoms such as fatigue, cognitive difficulties, and mood changes. These symptoms closely resemble those seen in patients with GHD. One proposed explanation for this similarity is that untreated neuroendocrine dysfunction post-msTBI contributes to the neurocognitive deficits seen in this population. Objective: This study examines QOL differences between msTBI patients with and without GHD. The goal was to evaluate the impact of untreated GHD on QOL in patients with msTBI, compared to those without GHD. We hypothesize that patients with TBI with GHD have a lower QOL relative to patients with TBI without GHD. Methods :This case-control study prospectively enrolled msTBI particpants from a single-center neuroendocrine database. Inclusion criteria were GCS

3–12, loss of consciousness >30 minutes, or post traumatic amnesia >24 hours. GHD was diagnosed using the glucagon stimulation test at least one year post-injury, with criteria adjusted for BMI and pre test probability. Patients with msTBI and GHD were matched 1:1 to msTBI controls without GHD by sex, TBI severity, GOSE score at QOL assessment, age (±5 years), and time since injury, resulting in 69 matched pairs (n=138). QOL was measured using the QOLIBRI survey, which assesses six domains. Mean domain and item scores were compared using two-sided t-tests. Multivariate ordinary least squares (OLS) regression was performed, controlling for participant group, age, sex, TBI severity, GOSE score, QOLIBRI domain, and interaction terms for participant group × domain and GOSE × domain. Results: msTBI patients with GHD had significantly lower QOLIBRI scores in the Emotions (p=0.006) and Feelings (p=0.03) domains compared to those without GHD. OLS regression showed that absence of GHD was associated with higher overall QOL (β=3.2, p<0.001). Significant predictors of QOL included the Feeling, Independence, Physical,

and Thinking domains. GOSE score was positively associated with QOL in the Independence (β=2.8, p<0.001) and Thinking (β=1.5, p<0.001) domains. The model explained 68% of QOL variance (adjusted R²=0.68). Conclusion : GHD is associated with significantly lower QOL, particularly in emotional and affective domains. These findings support routine endocrine screening in TBI populations and highlight the need for further research into the benefits of growth hormone replacement therapy for optimizing recovery in this population. IRB Statement: This study was approved by the Carilion Clinic IRB, protocol number 24-1930.

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175 2026 Research Recognition Day