[Clinical usefulness of screening for dysthyroidism with an ultrasensitive thyroid-stimulating hormone (TSH) assay in patients hospitalized in geriatric units].
OBJECTIVE
Thyroid disease is common in elderly subjects but as diagnosis is difficult, systematic screening is widely proposed. The clinical usefulness in terms of therapeutic impact has not been proven.


METHODS
We investigated the clinical usefulness of screening for dysthyroidism using ultrasensitive TSH assay (TSHus) in 657 unselected patients hospitalized in a geriatric unit. TSHus was performed at admission in all patients and completed by a full laboratory work-up in case of abnormal results. Therapeutic decisions were recorded from the medical file.


RESULTS
Mean patient age was 82 +/- 7 years, 74% were women. Prior history or current drug regimen were indications for TSHus assay in 144 patients (21.9%) who comprised group 2. In 513 other patients (group 1) the situation was one of true systematic screening. Hypothyroidism was diagnosed in 24 patients in group 1 (4.7%) and hyperthyroidism in 25 (4.9%). In group 1, few specific therapeutic measures were taken and involved only 6 patients (1.2%). Medical counseling was however provided for 37 patients (7.2%).


CONCLUSIONS
Dysthyroidism is common in the elderly hospital population and systematic screening using TSHus is warranted at admission. However, the clinical impact of screening is minimal since few therapeutic measures are subsequently taken.
Madjlessi
A
A
Service de Gériatrie, Institution Nationale des Invalides, Paris.
Pariel-Madjlessi
S
S
Belmin
J
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006757:Hospital Units; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D007297:Inpatients; D008297:Male; D008403:Mass Screening / Q000379:methods; D015995:Prevalence; D012680:Sensitivity and Specificity; D013959:Thyroid Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D013972:Thyrotropin / Q000097:blood*
D013972:Thyrotropin