Prognostic Value of Thyroid Hormone Dysfunction and Age in Septicemic Post-Surgical Patients
Pallavi Rain
Department of Biochemistry, Santosh Medical College, Santosh University, Ghaziabad, Uttar Pradesh, India.
Jyoti Batra *
Department of Biochemistry, Santosh Medical College, Santosh University, Ghaziabad, Uttar Pradesh, India.
Ankit Batra
School of Medical Sciences, Sharda University, Greater Noida, Uttar Pradesh, India.
Satish Kumar
Department of Anaesthesia and Critical Care Medicine, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India.
Shaila Mitra
Department of Pathology, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Critical illness and sepsis are difficult to treat with increasing age because of the poor adaptive physiological system as age progresses. The study tries to identify prognostic markers among thyroid hormones for post-surgical critically ill subjects, who have sepsis, to improve the outcome of patients with increasing age.
Methods: Free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were estimated by ARCHITECT immunoassay kits in 127 post-surgical critically ill patients with sepsis. Sequential Organ Failure Assessment (SOFA) score was recorded for each patient.
Results: The FT3, FT4 and TSH levels decreased and SOFA score increased with increasing age. Thyroid markers were significantly inversely correlated with age (for FT4 r= -0.616, p<0.0001 and for TSH r= -0.453, p<0.0001), with the strongest correlation between FT3 and age (r=0.674, p<0.0001). A positive correlation was observed between SOFA score and age (r=0.577, p<0.0001). FT3 decreases, SOFA and age increase from improved prognosis to worst prognosis (p<0.0001).
Conclusions: FT3 surfaced as a prominent prognostic marker that may be used in predicting the prognosis of post-surgical critically ill geriatric patients with sepsis.
Keywords: Critical illness, sepsis, thyroid hormone, thyroid stimulating hormone, thyroxine, triiodothyronine, SOFA score