Alteration of levels of thyroid hormones in acute ischemic stroke and its correlation with severity and functional outcome

Abstract

Introduction – With increasing life expectancy and changing trends in diseases, lifestyle diseases come forward and become a major concern. Ischemic stroke is an emerging public health issue leading to significant morbidity and mortality. To improvise positive outcome in acute ischemic stroke (AIS) and optimizing healthcare resources, accurate and timed prognostication of functional outcome is important. Various studies implied derangement of Hypothalamo-pituitary-thyroid (HPT) axis in AIS, thereby advocates neuroprotective properties to these hormones. This is, still, an open field for active research. Thyroid hormones can, therefore, be used as a surrogate tool for outcome predilection in AIS. This prospective observational cohort study aimed to investigate the alteration of levels of thyroid hormones in AIS and simultaneously correlate their levels in assessment of clinical severity and predicting the functional outcome. Materials and methods – We had collected data from 60 patients of, radiologically confirmed new cases of AIS who sought medical help within 72 hours of initiation of stroke symptom and had no previous history of thyroid disease. Blood samples for thyroid function test [TSH, FreeT3 (FT3), and FreeT4 (FT4)] were collected within 24 hours after admission and subsequently at 7th and 30th day of discharge .On admission neurological clinical severity was assessed by using National Institute of Health Stroke Scale (NIHSS). Functional outcome was assessed by Modified Rankin Scale (mRS) at 7th and 30th day of discharge. Result – Out of 60 AIS patients, 40 were having Non thyroidal illness Syndrome (NTIS). Low T3 was most common NTIS observed. Negative correlation was observed between FT3 levels and on admission NIHSS score and mRS score on follow up. Conclusion – This study thereby concludes that low T3 levels were associated with clinical severity and poor functional outcome in AIS. Keywords: stroke, thyroid profile, correlation, NIHSS, mRS, NTIS.