Predictive value of thyroid hormone assessment in septic patients in comparison with C-reactive protein

Hosny, Mohamed; Rashad, Rania; Atef, Doaa; Abed, N

doi:10.1016/j.ejccm.2015.11.001

Cited by 14 publications

(17 citation statements)

References 16 publications

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“…Based on the following reasons, 19 studies were excluded: not a relevant population (n = 6), not a relevant outcome (n = 8), and review articles (n = 5). Finally, 8 studies and 1,578 enrolled patients, were included in the meta-analysis 2,11–17 . The main characteristics of these 8 studies are summarized in Table 1 and the definition of sepsis in each study was presented in Supplemental Table S1, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Previous clinical studies also demonstrated the association of the decrease in various TH levels such as T3, T4, thyroid stimulating hormone (TSH), fT3, and fT4 with mortality in septic patients 2,9–17 . As a result, the decrease in TH level has been considered as one of the potential predictors of mortality in septic patients 2,15–17 . Nevertheless, the prognostic impact of TH in mortality due to sepsis is still controversial.…”

Section: Introductionmentioning

confidence: 94%

“…Decreased thyroid hormone (TH) level has often been reported in septic patients. This phenomenon has been explained by the key role of TH in adapting metabolic function to sepsis 1,2 . The two mechanisms which result in low triiodothyronine (T3) and thyroxine (T4) in sepsis are (1) the excessive production of inactive reverse T3 from T4 and (2) the malfunction of hypothalamic-pituitary-thyroid axis by inflammatory cytokine 3,4 .…”

Section: Introductionmentioning

confidence: 99%

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The Value of Decreased Thyroid Hormone for Predicting Mortality in Adult Septic Patients: A Systematic Review and Meta-Analysis

Kim

Shin

Kim

et al. 2018

Sci Rep

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Decreased thyroid hormone (TH) has been considered as one of the potential predictors of mortality in sepsis. This study aimed to evaluate the prognostic impact of decreased TH on mortality in septic patients during intensive care unit (ICU) admission. We included studies that assessed thyroid function by measuring the serum thyroid hormone level and in-hospital mortality in adult septic patients. Reviews, case reports, editorials, letters, commentaries, animal studies, duplicate studies, and studies with irrelevant populations and inappropriate controls were excluded. A total of 1,578 patients from eight studies were included. Triiodothyronine levels in non-survivors were relatively lower than that of survivors (6 studies; standardized mean difference [SMD] 2.31; 95% confidence interval (CI), 0.52-4.10; I = 97%; P = 0.01). Thyroxine levels in non-survivors were also lower than that of survivors (5 studies; SMD 2.40; 95% CI, 0.91-3.89). There were no statistically significant differences in thyroid-stimulating hormone levels between non-survivors and survivors. The present meta-analysis suggested that the decreased TH during ICU admission might be associated with the increase in mortality in adult septic patients. Hence, the measurement of TH could provide prognostic information on mortality in adult septic patients.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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The Value of Decreased Thyroid Hormone for Predicting Mortality in Adult Septic Patients: A Systematic Review and Meta-Analysis

Kim

Shin

Kim

et al. 2018

Sci Rep

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“…Various studies have reported that nonsurvivors had very low thyroid biomarkers as compared to the survivors. [27][28][29] Although, most of the studies suggest definite association between thyroid dysfunction and worse outcome in sepsis, the findings are inconsistent and need further investigation. 30 In our study we observed the average serum FT3 level 1.73 ± 0.31 pg/mL in HSS group, while it was 2.03 ± 0.22 pg/mL in LSS group, though both the reading are in normal range; however, in HSS group it was significantly on lower side (p= 0.004; Figure 1a).…”

Section: Discussionmentioning

confidence: 99%

“…23 Low level of thyroid hormone is correlated with severity of illness along with SOFA in various studies. [24][25][26][27][28][29] Therefore, this observational study was intended to detect the thyroid biomarkers (FT3, FT4 and TSH) as independent predictors of ICU mortality in unselected post-operative patients. This study may be helpful in adding one more parameter to define the prognosis of these critically ill post-operative patients with sepsis along with SOFA, APACHE II and others.…”

mentioning

confidence: 99%

Role of Thyroid Biomarkers in Association With Sofa Score in Predicting the Prognosis of Post-Operative Critically Ill Patients

Rain¹,

Itagappa²,

Kumar³

et al. 2018

jemds

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BACKGROUND Thyroid hormone alterations in critically ill patients are very common and may add to the severity of disease and the outcomes of patients in Intensive Care Unit (ICU). This observational study was conducted to detect the thyroid biomarkers as independent predictors of ICU mortality to predict prognosis more accurately in post-operative critically ill ICU patients with sepsis.This study also tries to determine any association between the thyroid biomarkers and SOFA (sepsis-related organ failure assessment) score. MATERIALS AND METHODSThis is a prospective observational study. We investigated free triiodothyronine (FT3), free thyroxine (FT4) and Thyroid Stimulating Hormone (TSH) in low SOFA score patients (LSS; n= 21, SOFA= 0 -6) and in high SOFA score patients (HSS; n= 82, SOFA > 6). The serum levels of FT3, FT4 and TSH were correlated with SOFA score. Further, prognosis on fifth day of ICU admission was defined on the basis of SOFA score, FT3, FT4 and TSH. RESULTSThe serum levels of FT3 (p= 0.004), FT4 (p= 0.025) and TSH (p > 0.05) decreased in HSS than LSS. A negative correlation was observed between thyroid biomarkers and SOFA score (> 6). Patients who deteriorated on the fifth day of ICU admission had significantly high SOFA score (p= 2.15E-06) and significantly low FT3 (p= 3.17E-10), FT4 (p= 4.06E-05) and TSH (p= 2.21E-05) on first day of ICU admission than those who improved on fifth day. CONCLUSIONThyroid biomarkers, specifically low FT3 might be an efficient biomarker or risk factor in evaluating prognosis of the postoperative critically ill patients.

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Modulating the function of the immune system by thyroid hormones and thyrotropin

et al. 2017

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Predictive value of thyroid hormone assessment in septic patients in comparison with C-reactive protein

Cited by 14 publications

References 16 publications

The Value of Decreased Thyroid Hormone for Predicting Mortality in Adult Septic Patients: A Systematic Review and Meta-Analysis

The Value of Decreased Thyroid Hormone for Predicting Mortality in Adult Septic Patients: A Systematic Review and Meta-Analysis

Role of Thyroid Biomarkers in Association With Sofa Score in Predicting the Prognosis of Post-Operative Critically Ill Patients

Modulating the function of the immune system by thyroid hormones and thyrotropin

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