Relevance of TSH evaluation in elderly in-patients with non-thyroidal illness
| Autor: | Carina Parisi, J. Rosenfarb, Noelia Sforza, Gabriela Brenta, Tomás Meroño, P Fossati, Evelyn Blanc, Y Morosan Allo, Cristina Faingold, C. Frigerio, D. Caruso, R. Rujelman |
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| Rok vydání: | 2018 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Aging endocrine system diseases Hospitalized patients Endocrinology Diabetes and Metabolism Thyroid Gland 030209 endocrinology & metabolism Context (language use) Thyroid Function Tests Odds 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine medicine Humans Clinical significance In patient Prospective Studies Thyrotropin-Releasing Hormone Aged Aged 80 and over business.industry Odds ratio Length of Stay Prognosis Hospitalization 030220 oncology & carcinogenesis Critical illness Female Thyroid function business hormones hormone substitutes and hormone antagonists Follow-Up Studies |
| Zdroj: | Journal of endocrinological investigation. 42(6) |
| ISSN: | 1720-8386 |
| Popis: | Non-thyroidal illness (NTI) is frequent in hospitalized patients. Its recovery is characterized by a raise in TSH levels. However, the clinical significance of high TSH levels at admission in hospitalized elderly patients with NTI remains uncertain.To explore the relevance of baseline TSH evaluation in hospitalized elderly patients with NTI.We examined the participants with NTI (n = 123) from our previous study (Sforza, 2017). NTI was defined as: low T3 ( 80 ng/dL) and normal or low total T4 in the presence of TSH values between 0.1 and 6.0 mU/L. Thyroid function tests were performed on day 1 and day 8 of the hospital stay. Positive TSH changes (+ ΔTSH) were considered when the day-8 TSH value increased more than the reference change value for TSH (+ 78%). Multiple logistic regression was used to evaluate the independent association of baseline TSH, sex, clinical comorbidities (by ACE-27) and medications with + ΔTSH.Out of 123 patients (77 ± 8 years, 52% female), 34 showed a + ΔTSH. These patients had a lower TSH at admission (p 0.001) and intra-hospital mortality (p = 0.003) than the others. In multiple logistic regression, TSH 2.11 mU/L at baseline was associated with reduced odds to show + ΔTSH [odds ratio (95 CI) 0.29 (0.11-0.75); p = 0.011] in a model adjusted by age, sex and ACE-27.Inappropriately higher TSH levels at admission in hospitalized elderly patients were associated with a reduced ability to raise their TSH levels later on. The present results confront the idea that TSH levels at admission are irrelevant in this clinical context. |
| Databáze: | OpenAIRE |
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