Journals / Cukurova Medical Journal / 2023 / Cilt: 48 Sayı: 3

A new marker in determining the relationship between the clinical outcomes of patients with sepsis and thyroid function tests: free triiodothyronine to free thyroxine ratio

Sepsis hastalarının klinik sonuçları ile tiroid fonksiyon testleri arasındaki ilişkinin belirlenmesinde yeni bir belirteç: serbest triiyodotironinin serbest tiroksin oranı

Pages
1106–1114
Publication Date
2023-09-30
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It was found that the first fT3 levels (-0.83±0.45 v.s. -0.23±0.14) and fT3 / fT4 ratio (-0.73±0.62 v.s. -0.12±0.11) decreased significantly more at 48th hour in non-survivors than survivors.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Purpose: This study investigated the predictive value of thyroid hormones in septic patients.
📊
Key Findings & Data:Free triiodothyronine (fT3) and free thyroxine (fT4) levels taken at the time of hospitalization and at the 48th hours were measured and the fT3 / fT4 ratio was calculated.
💡
Conclusion & Impact:It was found that the first fT3 levels (-0.83±0.45 v.s. -0.23±0.14) and fT3 / fT4 ratio (-0.73±0.62 v.s. -0.12±0.11) decreased significantly more at 48th hour in non-survivors than survivors.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Serbest triiyodotironin/serbest tiroksin oranı · Yoğun bakım ünitesi · Sepsis

Abstract

Purpose: This study investigated the predictive value of thyroid hormones in septic patients. Materials and Methods: Our study was conducted in patients with sepsis in intensive care unit (ICU). Free triiodothyronine (fT3) and free thyroxine (fT4) levels taken at the time of hospitalization and at the 48th hours were measured and the fT3 / fT4 ratio was calculated. Calculated fT3 and fT4 change between first and 48th hours. Results: 192 patients with sepsis were included in the study. In non-survivor patients, first fT3 (1.60±0.57 ng/dL v.s. 2.01±0.41 ng/dL) and fT3 / fT4 ratio (1.34±0.88 v.s. 1.79±0.91) were found to be significantly lower than 48th hours fT3 (0.77±0.39 ng/dL v.s. 1.87±0.49 ng/dL) and fT3 / fT4 ratio (0.60±0.51 v.s. 1.66±1.21) survivors. It was found that the first fT3 levels (-0.83±0.45 v.s. -0.23±0.14) and fT3 / fT4 ratio (-0.73±0.62 v.s. -0.12±0.11) decreased significantly more at 48th hour in non-survivors than survivors. The 48th hours fT3 level and the change in fT3 between the first and 48th hour were found to be the most significant parameters for the mortality indicator. Conclusion: fT3 / fT4 ratio has predictive value for mortality in patients with sepsis in ICU. In addition, fT3 was found to be an indicator for mortality predictivity both at admission and at 48th hours.

Özet

Amaç: Çalışmamızda septik hastalarda tiroid hormonlarının prediktif değerini araştırdık. Gereç ve Yöntem: Çalışmamız yoğun bakım ünitesinde (YBÜ) yatan sepsis hastalarında yapıldı. Hastaneye yatış anında ve 48. saatte alınan serbest triiodotironin (sT3) ve serbest tiroksin (sT4) düzeyleri ölçüldü ve sT3/sT4 oranı hesaplandı. Birinci ve 48. saatler arasındaki sT3 ve sT4, değişikliği hesaplandı. Bulgular: Çalışmaya 192 sepsis hastası dahil edildi. Kaybedilen hastalarda birinci sT3 (1.60±0.57 ng/dL vs 2.01±0.41 ng/dL) ve sT3/sT4 oranı (1.34±0.88 vs 1.79±0.91), 48. saatteki sT3 (0.77±0.39 ng/dL vs 1.87±0.49 ng/dL) ve sT3/sT4 oranından (0.60±0.51 vs 1.66±1.21) yaşayanlara göre anlamlı olarak düşük bulundu. İlk sT3 düzeylerinin (-0.83±0.45 vs -0.23±0.14) ve sT3/sT4 oranının 48. saatte (-0.73±0.62 vs -0.12±0.11) kaybedilenlerde yaşayanlarda göre anlamlı olarak daha fazla azaldığı saptandı. 48. saat sT3 düzeyi ve ilk ile 48. saat arasındaki sT3 değişiminin mortalite göstergesi için en anlamlı parametreler olduğu bulundu. Sonuç: sT3/sT4 oranının YBÜ’deki sepsisli hastalarda mortalite için prediktif değere sahip olduğu gösterilmiştir. Ayrıca hem yatışta hem de 48. saatteki sT3 değerleri mortalite için anlamlı öngörücü göstergeler olduğu bulundu.

🔖

Cite This Article

YAKIŞIK, E., YÜCEL, Ç., KIZILGÜN, M., TURAN, I. Ö. (2023). A new marker in determining the relationship between the clinical outcomes of patients with sepsis and thyroid function tests: free triiodothyronine to free thyroxine ratio. Cukurova Medical Journal, Cilt: 48 Sayı: 3, 1106–1114. https://ajindex.com/articles/966069

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (10)

  1. Widmer A, Schuetz P. Endocrine dysfunction during sepsis are changes in hormone levels a physiological adaptation or a therapeutic target? J Lab Precis Med. 2018;3:61. Çakır U, Tayman C. The effect of thyroid functions on osteopenia of prematurity in preterm infants. J Pediatr Endocrinol Metab. 2019;32:65-70.
  2. Kim JG, Shin H, Kim W, Lim TH, Jang B, Cho Y et al. The value of decreased thyroid hormone for predicting mortality in adult septic patients: A systematic review and meta-analysis. Sci Rep. 2018;8:14137. Park SY, Park SE, Jung SW, Jin HS, Park IB, Ahn SV et al. Free triiodothyronine/free thyroxine ratio rather than thyrotropin is more associated with metabolic parameters in healthy euthyroid adult subjects. Clin Endocrinol (Oxf). 2017;87:87-96.
  3. Corona G, Solaroli E, Tortorici G, Sforza A. Heart and thyroid interactions. G Ital Cardiol (Rome). 2019;20:342-50.
  4. Yanni GN, Destariani CP, Lubis AN, Deliana M. Thyroid hormone profile in children with sepsis: does euthyroid sick syndrome exist? Open Access Maced J Med Sci. 2019;7:1110-3.
  5. Dai JJ, Du DF, Ma G, Jiang MJ. Association between serum-free thyroxine level and all-cause mortality in critically ill patients: a retrospective study from MIMIC-IV. Front Endocrinol (Lausanne). 2023;14:1164369. Patel D, Naik D, Kamalanathan S, Tamilarasu K, Sahoo J, Roy A et al. Thyroid function abnormalities and outcomes in hospitalized patients with COVID-19 infection: A cross-sectional study. Horm Metab Res. 2023;55:169-75.
  6. Lodha R, Vivekanandhan S, Sarthi M, Arun S, Kabra SK. Thyroid function in children with sepsis and septic shock. Acta Paediatr. 2007;96:406-9.
  7. Ray DC, Drummond GB, Wilkinson E, Beckett GJ. Relationship of admission thyroid function tests to outcome in critical illness. Anaesthesia. 1995;50:1022-5.
  8. Baral S, Shrestha PK, Pant V. Serum Free T3 to Free T4 ratio as a useful indicator for differentiating destruction induced thyrotoxicosis from Graves' Disease. J Clin Diagn Res. 2017;11:OC12-OC14. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315:801-10.
  9. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med. 2017;45:486-552.
  10. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13:818-