Alterations in thyroid function tests in aged hospitalized patients: prevalence, aetiology and clinical outcome

Iglesias, Pedro; Muñoz, Angélica; Prado, Florentino; Guerrero, María Teresa; Macías, M. C.; Ridruejo, Elena; Tajada, P.; Díez, Juan J.

doi:10.1111/j.1365-2265.2008.03421.x

Cited by 67 publications

(50 citation statements)

References 37 publications

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“…4 elderly patients without any comorbidity (2.9%) and 16 patients with comorbidity (14.8) have clinical hypothyroidism in our study. Low T3 syndrome was the most prevalent abnormality in both groups in our patients (30.4% and 40.7%; respectively) as founded by other studies in 32%-62% of older hospital patients [26][27] . Also, in a population of independently living elderly men, prevalence of low T3 syndrome founded to increase with age and the presence of disease [28] .…”

Section: Discussionsupporting

confidence: 67%

Comorbidity Assessment and Thyroid Hormones in Independently-Living Elderly

Abdelhai

salem

Gawish

2016

Zagazig University Medical Journal

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Background: the study was undertaken with an objective to study the spectrum of thyroid dysfunction in elderly and to correlate comorbidity with abnormal thyroid function. Methods: a total of 246 subjects aged more than 60 years, admitted to General Medicine or attended the outpatient clinic who were presented with vague symptoms like easy fatigability and lethargy, were subjected to detailed clinical examination and thyroid function testing by biochemical means. Results: a total of 246 patients were included in the study. Thyroid disorders were present in 51.2%. Clinical hypothyroidism in 8.13%, subclinical hypothyroidism in 4.88% cases, hyperthyroidism in 3.3% and Low triiodothyronine (T3) syndrome in about one third of our patients were noted. There were no correlation between the thyroid hormones and most of clinical and laboratory parametes. The prevalence of abnormal thyroid patterns were significantly high in patients with comorbidities in comparison to those without. Conclusions: Elderly patients especially those with comorbidity have high prevalence of thyroid dysfunction. Clinical diagnosis is difficult to make because of vague symptomology and comorbid diseases. So, high clinical suspicion and thyroid function tests always helps in diagnosing the disease.

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Section: Discussionsupporting

confidence: 67%

Comorbidity Assessment and Thyroid Hormones in Independently-Living Elderly

Abdelhai

salem

Gawish

2016

Zagazig University Medical Journal

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“…In hospitalized patients, thyroid hormone alterations are very common, particularly in those of increased age or in those with critical illness (2,3). Low triiodothyronine (T 3 ) is commonly observed in the latter group of patients, which can be attributed to increased deiodination of thyroxine (T 4 ) to reverse T 3 (rT 3 ), rather than T 3 , and increased catabolism of T 3 to 3,3-diiodothyronine (T 2 ) (4-6).…”

Section: Introductionmentioning

confidence: 99%

Association between thyroid function tests at baseline and the outcome of patients with sepsis or septic shock: a systematic review

Angelousi

Karageorgopoulos

Kapaskelis

et al. 2011

European Journal of Endocrinology

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Introduction: The severity of critical illness is associated with various patterns of thyroid hormone abnormalities. We sought to evaluate whether the outcome of patients with, specifically, sepsis or septic shock is associated with the thyroid function tests evaluated at diagnosis or admission in the intensive care unit (ICU). Methods: We performed a systematic review of relevant studies by searching PubMed. Results: We included nine studies that all had a prospective cohort design. Seven involved children or neonates, and two involved adults. Mortality was the outcome evaluated in eight studies, while the length of ICU stay was evaluated in the remaining study. In univariate analysis, six of the nine included studies showed that either, free or total, triiodothyronine or thyroxine was lower in the group of patients with sepsis or septic shock who had unfavorable outcome than in those who had favorable outcome. Two other studies showed higher TSH values in the group of patients with unfavorable outcome. No significant relevant findings were observed in the remaining study. Regarding the correlation of sepsis prognostic scoring systems with thyroid function tests, the three studies that provided specific relevant data showed variable findings. Discussion: Most of the relevant studies identified favor the concept that decreased thyroid function at baseline might be associated with a worse outcome of patients with sepsis or septic shock. Although these findings are not consistent, the role of thyroid function in affecting or merely predicting the outcome of sepsis or septic shock merits further investigation.

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“…While the diagnosis of hypothyroidism has been reported in about 2% of this population, 4 non-thyroidal illness (NTI), also known as euthyroid sick syndrome, is the main finding. 5 The laboratory parameters of NTI usually include low serum levels of T3 and normal or low serum levels of T4 and TSH. Iglesias et al 5 reported that out of 447 elderly hospitalized patients, 332 (74.3%) had some kind of alteration of TSH and/ or thyroid hormones.…”

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confidence: 99%

High TSH and low T4 as prognostic markers in older patients

Mingote¹,

Meroño²,

Rujelman³

et al. 2012

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th percentile), and mortality assessed during an 18-month follow-up period after their hospital discharge. rESulTS: Out of 2599 older patients admitted to our hospital, 7% had TFT performed for various reasons. The patients who had TFT were mostly women and presented in a more serious clinical condition compared to the rest of the patients. The patients were grouped as per their thyroid values as follows: 61% of them had a non-thyroidal illness, 25% were euthyroid, 7% had overt hyperthyroidism, 5% overt hypothyroidism and 1% had subclinical hyper-or hypothyroidism. The hypothyroid patients had a worse clinical outcome compared to the others. Patients with increased MM exhibited higher TSH and lower TT4 (p<0.005). Short-term MM (Or=2.0,95%cI=1.1-3.6, p<0.01) was associated with the decrease of TT4 adjusted by age, sex, T3 and TSH, while for long-term MM the increase in TSH (Or=1.6,95%cI 1.1-2.3, p<0.05) was also significant. cONcluSION: Among hospitalized older patients who had TFT tests, low TT4 and high TSH were associated with a worse prognosis. We propose that TFT be used as an additional tool in assessing MM in elderly hospitalized patients.

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Alterations in thyroid function tests in aged hospitalized patients: prevalence, aetiology and clinical outcome

Abstract: About three quarters of patients admitted in our geriatric unit exhibited alterations in thyroid function tests. This finding was associated with elevated age and poor prognosis. The reduction of FT3 values was a powerful predictor for mortality during hospitalization in elderly patients.

Cited by 67 publications

References 37 publications

Comorbidity Assessment and Thyroid Hormones in Independently-Living Elderly

Comorbidity Assessment and Thyroid Hormones in Independently-Living Elderly

Association between thyroid function tests at baseline and the outcome of patients with sepsis or septic shock: a systematic review

High TSH and low T4 as prognostic markers in older patients

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