title: Comparison and relationship of thyroid hormones, IL-6, IL-10 and albumin as mortality predictors in case-mix critically ill patients.
abstract: OBJECTIVE
  To compare the ability of thyroid hormones, IL-6, IL-10, and albumin to predict mortality, and to assess their relationship in case-mix acute critically ill patients.
  
  
  METHODS
  APACHE II scores and serum thyroid hormones (FT3, FT4, and TSH), IL-6, IL-10, and albumin were obtained at EICU admission for 79 cases of mix acute critically ill patients without previous history of thyroid disease. Patients were followed for 28 days with patient's death as the primary outcome. All mean values were compared, correlations assessed with Pearson' test, and mortality prediction assessed by multivariate logistic regression and ROC.
  
  
  RESULTS
  Non survivors were older, with higher APACHE II score (p=0.000), IL-6 (p<0.05), IL-10 (p=0.000) levels, and lower albumin (p=0.000) levels compared to survivors at 28 days. IL-6 and IL-10 had significant negative correlation with albumin (p=0.001) and FT3 (p ⩽ 0.05) respectively, while low albumin had a direct correlation with FT3 (p<0.05). In the mortality prediction assessment, IL-10, albumin and APACHE II were independent morality predictors and showed to have a good (0.70-0.79) AUC-ROC (p<0.05). Despite that the entire cohort showed low FT3 serum levels (p=0.000), there was not statistical difference between survivors and non-survivors; neither showed any significance as mortality predictor.
  
  
  CONCLUSIONS
  IL-6 and IL-10 are correlated with Low FT3 and hypoalbuminemia. Thyroid hormones assessed at EICU admission did not have any predictive value in our study. And finally, high levels of IL-6 and IL-10 in conjunction with albumin could improve our ability to evaluate disease's severity and predict mortality in the critically ill patients. When use in combination with APACHE II scores, our model showed improved mortality prediction.
authors.affiliation: Emergency Intensive Care Unit, Emergency Department of Xiangya Hospital - Central South University, 87 Xiangya Road, Changsha 410008, China.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Quispe E
authors.affiliation: Emergency Intensive Care Unit, Emergency Department of Xiangya Hospital - Central South University, 87 Xiangya Road, Changsha 410008, China. Electronic address: lxm8229@126.com.
authors.forename: Xiang-Min
authors.initials: XM
authors.lastname: Li
authors.affiliation: Department of Molecular Biology, Xiangya Hospital - Central South University, 87 Xiangya Road, Changsha 410008, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yi
mesh_terms: D018806:APACHE; D016638:Critical Illness / Q000401:mortality*; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D016015:Logistic Models; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012709:Serum Albumin / Q000032:analysis*; D015996:Survival Rate; D013963:Thyroid Hormones / Q000097:blood*; D013997:Time Factors
chemical_list: D015850:Interleukin-6; D012709:Serum Albumin; D013963:Thyroid Hormones; D016753:Interleukin-10
keywords: Albumin; Cytokines; Mortality; Thyroid hormones