Clinical significance of low triiodothyronine syndrome in critical patients and triiodothyronine impact on evaluation of prognosis
10.3760/cma.j.issn.1671-0282.2013.10.014
- VernacularTitle:低T3综合征在急诊重症患者发病率及T3对预后的评估
- Author:
Haiyan ZHANG
;
Lei DONG
;
Caijun WU
;
Fei ZHAO
- Publication Type:Journal Article
- Keywords:
Critical;
Low triiodothyronine syndrome;
Prognosis;
ROC curves;
APACHE Ⅱ score;
Intensive care unit;
Euthyroid sick syndrome
- From:
Chinese Journal of Emergency Medicine
2013;22(10):1132-1135
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify the clinical significance of low triiodothyronine syndrome and the potential impact of triiodothyronine (T3) on prognosis in critical patients.Methods A total of 150 critically ill patients enrolled from October 2012 to April 2013 were divided into two groups,namely low thyroidhormone group (n =38,group A) and normal T3 group (n =112,group B).APACHE Ⅱ scores of patients were recorded at admission and thyroid hormone levels were measured on the first and the third day after admission.Then the survival state of 28-day in each group was observed and then the relationship between prognosis and T3 levels was analyzed by receiver operating characteristic (ROC) curve.Results About 25.3% of 150 critical patients were suffered from low thyroidhormone syndrome and the mortality rate in this group was 42.1%,which was much higher than 29.5% in normal T3 group.There was no difference in prediction of death rate analyzed by ROC curve between the T3 level and APACHE Ⅱ scores.The area under curve of T3 level was 0.768 (95% CI:0.701-0.835) and APACHE Ⅱ was 0.783 (95%CI:0.719-0.846).Best cut-off value of T3 level was 0.41 ng/mL resulting in 76.6% sensitivity and 78.4% specificity.Conclusions Critically ill patients complicated with low thyroidhormone syndrome has poor prognosis and T3 may be a predictive marker in evaluating the prognosis of critically ill patients.