Thyroid Function, Reverse Triiodothyronine, and Mortality in Critically Ill Clinical Patients.

Autor: da Silveira CD; Programa de Pós-Graduação em Ciências da Saúde, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., de Vasconcelos FP; Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., Moura EB; School of Medicine, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., da Silveira BT; School of Medicine, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., Amorim FF; School of Medicine, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., Shintaku LS; School of Medicine, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., de Santana RB; School of Medicine, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., Argotte PL; School of Medicine, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., da Silva SF; Adult Intensive Care Unit, Hospital Santa Luzia - Rede D'Or São Luiz, Brasilia, Distrito Federal, Brazil., de Oliveira Maia M; Programa de Pós-Graduação em Ciências da Saúde, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil., Amorim FF; Programa de Pós-Graduação em Ciências da Saúde, Escola Superior de Ciências da Saúde, Brasília, Distrito Federal, Brazil.
Jazyk: angličtina
Zdroj: Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine [Indian J Crit Care Med] 2021 Oct; Vol. 25 (10), pp. 1161-1166.
DOI: 10.5005/jp-journals-10071-24001
Abstrakt: Background: To evaluate the association of thyroid hormones changes, including increased reverse triiodothyronine (rT3) level, with critically ill clinical patients´ mortality.
Patients and Methods: This study analyzed the observational data prospectively collected over 8 months (2018) in an adult intensive care unit (ICU) in Brasilia, Brazil. All consecutive ICU-admitted clinical patients were included. Thyroxine (T4), free thyroxine (fT4), triiodothyronine (T3), free triiodothyronine (fT3), rT3, and thyroid-stimulating hormone (TSH) were collected within 48 hours of ICU admission. Patients with hypothyroidism or hyperthyroidism who were previously diagnosed were excluded.
Results: Of 353 included patients, age was 68.5 ± 19.0 years, sequential organ failure assessment (SOFA) score was 3.3 ± 2.9, and Acute Physiology and Chronic Health Evaluation II (APACHE II) was 17.1 ± 7.9. ICU mortality was 17.6% ( n = 62). Non-survivor patients had a higher incidence of increased rT3 (69.3 vs 59.2%, p = 0.042), lower incidence of low T4 (4.8 vs 9.7%, p = 0.045), and increased age (75.2 ± 16.3 years vs 67.1 ± 19.3 years, p = 0.001), SOFA (3.0 ± 0.4 vs 2.8 ± 2.6, p <0.001), and APACHE II (23.5 ± 7.5 vs 15.7 ± 7.2, p <0.001). Alterations in other thyroid hormones did not show association with mortality. Increased rT3 [odds ratio (OR): 2.436; 95% confidence interval (CI): 1.023-5.800; p = 0.020] and APACHE II (OR: 1.083, 95% CI: 1.012-1.158; p = 0.044) were associated with ICU mortality in the multivariate analysis.
Conclusion: Increased rT3 was independently associated with increased ICU mortality. In contrast, other thyroid hormone alterations did not show an association with mortality. Determining rT3 levels may be a helpful test to identify an increased risk for ICU mortality in clinical patients.
How to Cite This Article: da Silveira CDG, de Vasconcelos FPJ, Moura EB, da Silveira BTG, Amorim FFP, Shintaku LS, et al. Thyroid Function, Reverse Triiodothyronine, and Mortality in Critically Ill Clinical Patients. Indian J Crit Care Med 2021;25(10):1161-1166.
Competing Interests: Source of support: Nil Conflict of interest: None
(Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)
Databáze: MEDLINE
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