Impact of Thyroid Dysfunction in Correlation to Mortality Rate of the Critically ILL ICU Patients (Prospective Observational Study)

Abstract

Abstract Background during critical illness, changes in circulating hormonal levels are a common phenomenon. These alterations are correlated with the severity and outcome of patients in intensive care unit (ICU). Thyroid hormone stays a key role in the maintenance of the body growth. Modulating metabolism and the immune system. Aim of the Work is to access the relation between thyroid dysfunction and mortality in critically ill patients and to access the strength of thyroid dysfunction as a predictor of mortality against APACHE II score and CRP, also to assess the additive effect of low FT3 and high APACHE II score as a predictor of mortality. Patients and Methods the study population (n = 40) included 21 males (52.2%) and 19 females (47.5). their age range from (21 years) to (91 years) were selected from critically ill patients admitted to El Demerdash hospital general ICU in the period from March 2017 to March 2018. Patients were divided into 2 groups according to 7th day thyroid profile: Group 1 Normal thyroid function group (24 patients). Group 2 thyroid dysfunction group (16 patients). Results the most significant abnormality between the 2 groups was TT3 and FT3. The patients in thyroid dysfunction group showed significantly higher APACHE II score and CRP but lower GCS. They also needed more mechanical ventilation with longer duration. There was no significant difference between the 2 study groups as regard cardiovascular complication. Conclusion our study also showed highly significant correlation between thyroid dysfunction and mortality. FT3 appeared to be better predictor of mortality among critically ill patients with AUC 83% and p value < 0.001 with sensitivity 99% and specificity 61%. The predictive value of FT3 for mortality increased by the addition of APACHE II score > 25.