[The euthyroid sick syndrome in severe acute illness].
OBJECTIVE
To describe euthyroid sick syndrome (ESS) and its different clinical variants in severe acute illness.


METHODS
This prospective cohort study examined hormone results and outcome for patients admitted to our intensive care unit (ICU).


METHODS
In this heterogeneous group of 108 patients from our ICU we analyzed the prevalence of ESS and its influence on mortality and sought to determine if any thyroid indicators had a prognostic value.


RESULTS
The prevalence of ESS was similar to that described by other authors (68.5% for ESS type I, 15.7% for type II and 1.9% for type III). Patients developed thyroid alterations on their third day of hospitalization and those with ESS type II had a higher mortality rate. The only thyroid indicator with prognostic value was a reverse triiodothyronine (rT3) value exceeding 0.61 ng/mL.


CONCLUSIONS
Severe acute illness induced the thyroid alterations known as ESS. Type I had the highest prevalence, but type II was correlated with a higher mortality rate. The only thyroid indicator with a prognostic value was rT3.
Bayarri
Vicente Miguel
VM
Secretaria UCI, Hospital Universitario Dr. Peset, Valencia, Spain. miguel_vic@gva.es
Sancho
Susana
S
Campos
Carmen
C
Faus
Rafael
R
Simón
Jose M
JM
Porcar
Elena
E
Tormo
Constantino
C
Hernandez
Antonio
A
D000208:Acute Disease; D005067:Euthyroid Sick Syndromes / Q000145:classification / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D011446:Prospective Studies; D012720:Severity of Illness Index