Highlights
- •Low FT3 in hospitalized patients is associated with mortality.
- •Elevated FT4 levels in chronic patients have an additional risk for mortality.
- •Decreased FT3 with an elevated FT4 is an independent predictor for the mortality.
Abstract
Background
Non-thyroidal illness syndrome is characterized by decreased serum free T3 (FT3) level
and associates with long term mortality. Serum free T4 (FT4) may affect on mortality
with FT3 in course of chronic illness. This study performed to evaluate the association
between both decreased FT3 with elevated FT4 levels and mortality risk.
Methods
This study is a retrospective cohort analysis and consisted up 1164 (571 male, 593
female) patients with a 36 months follow up period. Patients divided into four groups
according to thyroid functions. Patients with euthyroidism were in Group A, elevated
FT3 in group B, decreased FT3 in group C and both decreased FT3 and elevated FT4 levels
in group D. The levels of thyroid hormones and all cause mortality were compared between
four groups.
Results
Mortality rate was elevated between Groups A and B, A and C, A and D, B and C, B and
D, C and D, (p < .001, p < .001, p < .001, p < .001, p < .001, p:0.019, respectively). A multivariate
Cox proportional hazards model was performed to evaluate the mortality risk between
groups. A close relationship was observed in Group C and D patients for the mortality
risk (OR:1.561, 95% CI:1.165–2.090, p:0.003 and OR:2.224, 95% CI:1.645–3.006, p:0.0001,
respectively).
Conclusion
Both decreased FT3 and elevated FT4 levels are independent predictor for long term
mortality risk in hospitalized chronic patients with non-thyroidal illness syndrome.
Keywords
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Article info
Publication history
Published online: July 17, 2018
Accepted:
July 12,
2018
Received in revised form:
July 9,
2018
Received:
February 19,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
