RELATIONS AMONG PLASMA PROLACTIN, TESTOSTERONE, AND INJURY SEVERITY IN WAR CASUALTIES

Tissue trauma leads to a complex hormonal response of pituitary end-or gan axis. This response can be recorded by determining parameters that represent the functional integrity of these systems. The concentratio ns of serum prolactin (PRL), serum testosterone, and plasma adrenocort icotropin (ACTH) were measured in 62 adult male casualties from the re cent war in former Yugoslavia. Patients with brain injury were not inc luded. Venous blood samples were taken as soon as possible (2-18 hours ) after admission and at 1, 2, 5, and 14 days after injury. The severi ty of gunshot/missile wounds was assessed by the Injury Severity Score (ISS). The control group consisted of healthy blood donors. Uninjured subjects who had undergone great stress an the battlefield (explosion in the vicinity without injury) served as the sham-control group, Tis sue trauma leads to a severity-dependent decrease in serum testosteron e concentrations during the first 5 days following injury. Significant correlations were observed between ACTH, prolactin, and ISS during th e first 18 hours after injury. A strong negative correlation between t estosterone and prolactin serum concentrations was found during the fi rst 18 hours. In patients with additional complications or unsatisfact ory outcome, the prolactin concentrations remained elevated, whereas t estosterone concentrations were reduced. Our results support the usefu lness of recording hormonal changes for determining trauma severity an d monitoring the clinical course. Such monitoring also helps assess th e efficacy of therapeutic strategies. The relation between testosteron e and prolactin might be helpful for predicting the clinical course an d trauma outcome.