The ultra-acute steroid response to traumatic injury: a cohort study
Authors' conclusion
Changes in steroid biosynthesis and metabolism occur within minutes of traumatic injury. Studies that address whether ultra-early changes in steroid metabolism are associated with patient outcomes are now required.
Study context
- Population
- Adult male trauma patients <60 years (mean age 28 [range 19–59] years; mean injury severity score (ISS) 16 [IQR 10–21]); samples drawn by pre-hospital emergency responders, follow-up 4–12 and 48–72 h post-injury
- Participants
- 31 vs 34
- Exposure
- Trauma patients vs age- and sex-matched healthy controls
- Trauman = 31
- Healthy controls (HCs)n = 34reference
- Outcome
- Serum steroids by tandem mass spectrometry (ultra-acute steroid response to trauma)
- Follow-up
- Within 1 h of injury (median time to first sample 35 [range 14-56] min)
Methodological detailspre-hospital sampling ≤1 h of major trauma, age- and sex-matched healthy controls
- Pre-hospital sampling ≤1 h of major trauma
- Age- and sex-matched healthy controls
Main finding
As reported in the abstract
Serum steroids · within 1 h of injury
- Increase in glucocorticoid and adrenal androgen biosynthesis
- Cortisol and 11-hydroxyandrostendione increased rapidly
- Cortisone and 11-ketoandrostenedione decreased, reflecting increased 11β-hydroxylase activity and increased cortisol activation by 11β-hydroxysteroid dehydrogenase type 1
- Testosterone and 5α-dihydrotestosterone decreased
- 11-ketotestosterone maintained pre-injury levels
Observational data: associations, not effects.
Original publication
The ultra-acute steroid response to traumatic injury: a cohort study. Eur J Endocrinol. Published 21 February 2023. doi:10.
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