Evaluation of thyroid hormone levels in critically ill patients

Abstract

Aim: To analyse thyroid hormone levels in critically ill patients.
Material and Methods: This prospective hospital based study was carried out at Department of InternalMedicine over a period of twelve months, after the approval of the ethical committee. This study was carried out including 100 cases of critically ill patients admitted and treated in the intensive care unit (ICU), after considering the inclusion and exclusion criteria.
Results: Out of 100 patients included in study, 42 (42%) patients required Ventilator assistance, whereas 58 (58%) patients didn’t
required Ventilator. A total of 22 patients (22%) succumbed to their illness during ICU admission. 78 patients were survivors.
The mean APACHE-II score was significantly higher among non-survivorscompared with survivors (25.52 ± 6.84 vs. 14.06 ±
5.71, P < 0.01). In our study, APACHE II score which is calculated within 24 hoursof ICU admission is compared with thyroid
function tests which is taken on day1. The results obtained with this comparison is that on day 1 levels of FT3 and FT4 were significantly correlated with APACHE II scores whereas TSH levelwas not statistically significant.
Conclusion: We observed that FT3 and FT4 were the strongest predictor of ICU mortality compared to all other parameters included in our study. Further, the combination of FT3, FT4 levels and APACHE-II scores provided for a higher probability for predicting mortality in ICU patients.