Thyroid Function Tests and Mortality in Aged Hospitalized Patients: A 7-Year Prospective Observational Study

Abstract

Alterations in TFT results during hospitalization are associated with long-term mortality in elderly patients. In particular, low FT₃ levels are significantly related to all-cause and CV mortality.

The combination of nonthyroidal illness syndrome and renal dysfunction further increases mortality risk in patients with acute myocardial infarction: a prospective cohort study

“…Altay et al [32] also indicated that inflammatory status of the upper normal TSH tertile correlated negatively with FT3 in women may mediate mortality or nonfatal cardiac events rather than the action of thyroid hormone. Therefore, NTIS has been suggested to be associated with increased overall and cardiovascular death [5][6][7][8][9]. Similarly, glomerular hyperfiltration is associated with autoimmune activation and low-grade inflammation, leading to chronic diseases like ischemic heart disease [33].…”

“…For example, Iervasi et al [7] reported that patients with NTIS had 1.6 times the risk of cardiovascular mortality than euthyroid patients. Iglesias et al [9] also found that FT 3 was an independent predictor of cardiovascular mortality in patients aged over 65 years.…”

Elevated TSH in adults treated for hypothyroidism is associated with increased mortality

“…Thyroid function disorders are common in the general population, and the prevalence of overt hypothyroidism ranges between 1% and 7% (1,2). Although autoimmune thyroiditis is the most common cause of hypothyroidism in elderly subjects, other causes, such as drugs, neck radiotherapy, thyroidectomy or radioiodine therapy are frequently observed in this population (3).…”

“…Waring et al reported that a single measurement of thyroidstimulating hormone (TSH) and free T4 (fT4) did not predict the mortality in older men (7). Iglesias et al investigated thyroid function in hospitalized patients and demonstrated an association between alteration in thyroid function tests during hospitalization and long-term mortality in elderly patients (1). Furthermore, a recent study reported that higher TSH and lower fT4 concentrations within the normal range are associated with lower risk of mortality in elderly patients (18).…”

Are Thyroid Hormone Values Obtained in Hospitalized Elderly Patients Reproducible? - A Cohort Study

“…The significance of thyroid stimulating hormone (TSH) levels in hospitalized patients is unknown and may be influenced by various factors associated with hospitalization, such as treatment with glucocorticoids and infection. This condition, referred to as non-thyroidal illness syndrome (NTIS) has been reported to be present in up to 70 % of hospitalized patients [1][2][3]. Thus, reliance on thyroid function tests in hospitalized patients is questionable and treatment decisions are infrequently based on laboratory values performed in hospitalized patients.…”