Evaluation of serum thyroid hormone profile and its correlation with the clinical outcome in critically ill children

Critical illness is often accompanied by sick euthyroid syndrome, an endocrine anomaly with characteristically low triiodothyronine (T3), low thyroxine (T4), and altered thyroid-stimulating hormone (TSH) levels in the serum. This warrants exploration of the relationship between thyroid hormone levels and clinical outcome of critical illness. To evaluate the thyroid hormone profile in critically ill children and assess its correlation with disease severity and outcome. Fifty critically ill children, aged 1 month-15 years, admitted to the pediatric intensive care unit with organ dysfunction and requiring pharmacological/mechanical support to maintain vital function, were recruited into this observational study. Risk of Mortality (PRISM) scores were evaluated for all patients as an indicator of disease severity and their thyroid profile investigated for serum T3, T4, and TSH levels. These were correlated with each other and with the disease outcome using statistical software R version 3.6.3. At the end of hospital stay, mean T3, T4, and TSH levels were significantly increased in discharged patients (p<0.001) but reduced in expired patients (p=0.01) compared to their values at admission. Mean T4 levels at discharge/death showed a significant negative correlation with the mean PRISM score recorded 24 h after admission.&nbsp