[Prevalence and prognostic relevance of sick euthyroid syndrome in intensive care unit patients in Emam Reza Hospital]

ABSTRACT

Altered thyroid function in patients with non-thyrodial illness is a usuall finding and these biochemical changes called sick euthyroid syndrome [SES]. Our propose from this research is to estimate the relative frequency of SES and prognostic relevance of alteration in thyroid function indices in critically ill patients whom admitted in ICU. This prospective analitical study was preformd in Imam Reza Hospital intensive care unit patients. A specimen of venous blood was collected within the first 24 hours of admission for the evaluation of the baseline thyroid function indices and second specimen was collected at the time of patient death or discharge from ICU. T4, T3 [RIA] T[3] RU [RIA method], TSH [IRMA] and free T[4] [Direct one step RIA] were measured for all patients There were 29 males and 21 females, with age range of 16 to 83 years and mean age of 44 years [ 44+21.9]. Thirthy three patients [66%] showed evidence of SES and 17 patients [34%] were as non SES group. Mortality rate in SES and non -SES group was 24 and 3 patient respectively [72% vs. 17.6%, P < 0.01]. The commonest profile of thyroid indices was isolated low total T[3] [type I SES], and then combined low total T[3] and T[4] [Type II SES]. We found low [T3] [type I] in 51% of patients, and low T[3] and T[4] [type II] in 49% of them Relative morality rate have not any difference in two groups. Comparison of mean values of thyroid indices between single system and multi system illness groups showed statistical difference in TSH [P= 0.05] and FT4. [P=0.031] Comparison of thyroid indices between two survived and non survived group showed statistical difference in T3 [p = 0.047] and T[4] [P=0.036].Predictive value of normal T3 with good outcome measured 82% against 54% for normal T4. Relative frequency of SES in our patients was 66% and in them thyroid hormones have statistical relation with final outcome and severity of underling illness