Prevalence and prognostic relevance of sick euthyroid syndrome in a medical intensive care unit.
The prevalence and prognostic relevance of alterations in thyroid function indices in 100 critically ill patients were evaluated prospectively on admission to our medical intensive care unit (MICU). Patients with a present or past history of thyroid disorder and those on drugs that might interfere with thyroid function indices were excluded. Eighty-four (84%) of the patients had altered thyroid function indices suggestive of sick euthyroid syndrome (SES). The overall mortality rate for patients with and without evidence of SES were 40% and 6% respectively (P < 0.01). Serum total 3,3',5-triiodothyronine (T3) and total thyroxine (T4) concentrations were reduced in 67% and 24% of the patients respectively. The low T3 state and the low T3 and T4 state accounted for 55% and 29% of the SES cases respectively. No correlation was noted between the serum T4 concentration and survival outcome while a normal serum T3 value served as a good predictor for survival (97%). However, routine study of thyroid function indices in critically ill patients for its prognostic value is not encouraged as results are often heterogenous due to various limitations which will be discussed.
Loh
K C
KC
Department of General Medicine, Tan Tock Seng Hospital, Singapore.
Eng
P C
PC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003422:Critical Care; D016638:Critical Illness; D005069:Evaluation Studies as Topic; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D013577:Syndrome; D013961:Thyroid Gland / Q000503:physiopathology*; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine