A new prognostic index in surgery and parenteral feeding: the ratio of triiodothyronine to reverse triiodothyronine in serum (T3/rT3 ratio).
Serum concentrations of albumin, triiodothyronine (T3), and reverse triiodothyronine (rT3) were measured in 46 patients on the first day after routine gastrointestinal surgery, and the molar ratio T3/rT3 was calculated. The median value of this ratio, but not of albumin, was significantly lower in 11 who subsequently suffered major septic complications than in the remainder. Measurement of the ratio correctly predicted the outcome of 80% of individuals. The T3/rT3 ratio, midarm muscle circumference (MAMC), triceps skin fold (TSF) and serum concentrations of albumin and transferrin were measured in 23 patients at referral for parenteral feeding. Median values of T3/rT3 ratio, MAMC and transferrin, but not of the other parameters, were significantly lower in nine who died than in survivors. Measurements of the ratio, MAMC and transferrin correctly predicted the outcome of 87%, 78% and 74% of individuals, respectively.
Calvey
H D
HD
Department of Chemical Pathology and Liver Unit, King's College Hospital, London SE5 8RX UK.
Marshall
W J
WJ
Marsden
P D
PD
Davis
M
M