Relationship between Thyroid Function and ICU Mortality (Sick Euthyroid Syndrome)

Sick euthyoid syndrome refers to alterations in thyroid hormone levels in acutely ill patients. In early course of the illness, the peripheral conversion of T4 to T3 is reduced leading to decreased free T3 with normal or reduced T4 associated with an increase in reverse T3 (rT3) and no alterations in TSH. In prolonged illness, central hypothyroidism occurs leading to reduced TSH and T4 along with T3. In this study, thyroid hormone levels are assessed on day 1 and 7 when the patients are admitted in ICU. The sample size is 40 patients. Thyroid profiles are measured by immuno assay. The results are analyzed with the end point as whether the patient is alive and discharged or expired. In this study the thyroid hormone levels are also compared with APACHE II whether they can predict the outcome similar to that of APACHE II. CONCLUSION: In this study, we found that thyroid hormones can predict the mortality patients. Serial monitoring of thyroid hormone levels will increase the sensitivity. Of all the parameters T3 can significantly affect the outcome of the patients. Thyroid profile can also significantly improve the predictive level of APACHE II scores