title: Hypothyroidism as a protective factor in acute stroke patients.
abstract: OBJECTIVE
  It has been reported that hypothyroidism is associated with better survival in elderly persons. We investigated possible associations of thyroid status with clinical outcome in patients with acute stroke.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Consecutive patients (median age 70 years) admitted for acute stroke.
  
  
  METHODS
  Total T3, T4 and TSH levels. Stroke severity evaluation using the Scandinavian Stroke Scale (SSS) and the Glasgow Coma Score (GCS). Handicap and survival assessment over 12 months.
  
  
  RESULTS
  Of 744 patients where thyroid function tests were available within the first 24 h of stroke, 13 had elevated TSH (>or= 10 microU/ml; range 10-42 microU/ml) (hypo-group), 51 had mildly elevated TSH (3.3-9.9 microU/ml) and 680 had nonelevated TSH < 3.3 microU/ml. In the hypo-group transient ischaemic attacks (TIA's) were more prevalent (46.2%) compared to the groups of mildly elevated TSH (11.8%) and nonelevated TSH (12.4%, P < 0.002). Hypo-group had more frequently an adequate level of consciousness (GCS 14-15 = fully alert): 92.3%vs 74.5% and 63.7% (P = 0.033), a milder neurological deficit (SSS score 45-58) 76.9%vs 39.2% and 38.7% (P = 0.02) compared to the other two groups, respectively, and a tendency for lower glucose levels on admission. One year outcome tended to be better with respect to survival and handicap.
  
  
  CONCLUSIONS
  Acute stroke patients with laboratory findings compatible with pre-existing hypothyroidism on admission, appear to have better clinical presentation and outcome; we speculate that a reduced response to stress and previous TIA's, possibly related to endogenous 'preconditioning', may contribute to this phenomenon.
authors.affiliation: Endocrine Unit, Department of Medical Therapeutics, Athens University School of Medicine, Athens, Greece. mani@otenet.gr
authors.forename: Maria
authors.initials: M
authors.lastname: Alevizaki
authors.forename: Margaret
authors.initials: M
authors.lastname: Synetou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Xynos
authors.forename: Calliope C
authors.initials: CC
authors.lastname: Alevizaki
authors.forename: Kostas N
authors.initials: KN
authors.lastname: Vemmos
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000150:complications*; D002546:Ischemic Attack, Transient / Q000097:blood / Q000150:complications; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood / Q000150:complications*; D000071939:Stroke Rehabilitation; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine