The impact factors of prognosis in critical patients with abdominal infection and nonthyroidal illness syndrome

Abstract

Objective To explore the impact factors of prognosis in critical patients with abdominal infection and nonthyroidal illness syndrome. Methods Seventy-four abdominal infection patients admitted to intensive care unit (ICU) were enrolled in the Sixth Affiliated Hospital of Sun Yat-sen University, from January 2014 to January 2015.In the first day of ICU, free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), total thyroxine (TT4), thyroid stimulating hormone (TSH) and the levels of C-reactive protein (CRP), albumin, prealbumin were examined.The patients were divided into NTIS group and euthyroid group according to the level of the serum thyroid hormone. Results The incidence of NTIS was 82.5% in our study.The levels of age(69.6±7.8) and APACHE Ⅱ scores(16.2±3.3) of NTIS group were significantly higher than those of euthyroid group [ (59.1±5.4), (11.1±1.4), t=1.994, 1.981; P<0.05]; the level of albumin (26.7±4.2) of NTIS group was significantly lower than that of euthyroid group [ (31.1±2.3), t=1.979, P<0.05]. The levels of FT3(3.02±0.04), TT3(0.92±0.03), TT4 (82.20±1.14) of NTIS group were significantly smaller than those of euthyroid group [ (4.49±0.05), (1.74±0.05), (95.70±3.47), t=2.65, 2.64, 2.65; P<0.01], but the mortality in the hospital(3.28%), hospitalization time(31.00±6.00), the length of ICU stay(9.00±3.00), ventilation time(8.00±1.00) and hospitalization expenses (14.37±2.41) in NTIS group were significantly greater than those in euthyroid group[0, (17.00±7.00), (4.00±3.00), (3.00±1.00), (8.52±1.79), χ2=3.30, t=2.65, 2.60, 2.70, 2.66; P<0.05]. Using multivariate analysis of variance, the study found the APACHE Ⅱ score was veried as risk factor for mechanical ventilation and mortality. Conclusions NTIS is a common complication in critical patients with abdominal infection.Abdominal infection in critical patients with NTIS is associated with poor outcome and prognosis, but NTIS is not the risk factor for mechanical ventilation mortality in the critical ill patients.The APACHE Ⅱ score is varied as risk factor for mechanical ventilation and mortality. Key words: Nonthyroidal illness syndrome; Abdominal infection; Critical illness