Literature DB >> 22908068

High TSH and low T4 as prognostic markers in older patients.

Evelin Mingote1, Tomás Meroño, Rocío Rujelman, Alejandra Marquez, Pia Fossati, Mirta Gurfinkiel, Marta Schnitman, Fernando Brites, Cristina Faingold, Gabriela Brenta.   

Abstract

OBJECTIVE: To examine the association between thyroid profile and morbidity/mortality (MM) in hospitalized older patients.
DESIGN: This is a retrospective study of patients over the age of 60 yr admitted to the Dr. Cesar Milstein Hospital between 2009 and 2010 and who had thyroid function tests (TFT). The patients were grouped as per their thyroid tests and their clinical characteristics and MM was associated with their TFT. High MM was defined as mortality, intensive care unit (ICU) requirement or prolonged hospital stay (>18 days, 75th percentile), and mortality assessed during an 18-month follow-up period after their hospital discharge.
RESULTS: Out of 2599 older patients admitted to our hospital, 7% had TFT performed for various reasons. The patients who had TFT were mostly women and presented in a more serious clinical condition compared to the rest of the patients. The patients were grouped as per their thyroid values as follows: 61% of them had a non-thyroidal illness, 25% were euthyroid,7% had overt hyperthyroidism, 5% overt hypothyroidism and 1% had subclinical hyper- or hypothyroidism. The hypothyroid patients had a worse clinical outcome compared to the others. Patients with increased MM exhibited higher TSH and lower TT4 (p<0.005). Short-term MM (OR=2.0,95%CI=1.1-3.6, p<0.01) was associated with the decrease of TT4 adjusted by age, sex, T3 and TSH, while for long-term MM the increase in TSH (OR=1.6,95%CI 1.1-2.3, p<0.05) was also significant.
CONCLUSION: Among hospitalized older patients who had TFT tests, low TT4 and high TSH were associated with a worse prognosis. We propose that TFT be used as an additional tool in assessing MM in elderly hospitalized patients.

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Year:  2012        PMID: 22908068     DOI: 10.14310/horm.2002.1364

Source DB:  PubMed          Journal:  Hormones (Athens)        ISSN: 1109-3099            Impact factor:   2.885


  8 in total

1.  Hypothyroidism in hospitalized elderly patients: a sign of worse prognosis.

Authors:  N Sforza; J Rosenfarb; R Rujelman; M Rosmarin; E Blanc; C Frigerio; P Fossati; D Caruso; C Faingold; T Meroño; G Brenta
Journal:  J Endocrinol Invest       Date:  2017-05-22       Impact factor: 4.256

2.  High-TSH Subclinical Hypothyroidism Is Associated With Postoperative Mortality in Acute Type A Aortic Dissection.

Authors:  Shi-Pan Wang; Yuan Xue; Hai-Yang Li; Wen-Jian Jiang; Hong-Jia Zhang
Journal:  Front Endocrinol (Lausanne)       Date:  2022-04-29       Impact factor: 6.055

3.  Pre-admission TSH levels predict long-term mortality in adults treated for hypothyroidism.

Authors:  Amit Akirov; Tzipora Shochat; Amir Shechvitz; Ilan Shimon; Talia Diker-Cohen; Eyal Robenshtok
Journal:  Endocrine       Date:  2017-10-20       Impact factor: 3.633

4.  Relevance of TSH evaluation in elderly in-patients with non-thyroidal illness.

Authors:  J Rosenfarb; N Sforza; R Rujelman; Y Morosan Allo; C Parisi; E Blanc; C Frigerio; P Fossati; D Caruso; C Faingold; T Meroño; G Brenta
Journal:  J Endocrinol Invest       Date:  2018-10-26       Impact factor: 4.256

Review 5.  Clinical conundrums in management of hypothyroidism in critically ill geriatric patients.

Authors:  Vishal Sehgal; Sukhminder Jit Singh Bajwa; Rinku Sehgal; Anurag Bajaj
Journal:  Int J Endocrinol Metab       Date:  2014-01-05

6.  Clinical evaluation of various thyroid hormones on thyroid function.

Authors:  Hong Li; Xiaolan Yuan; Lu Liu; Jiaojiao Zhou; Chunyan Li; Peng Yang; Le Bu; Manna Zhang; Shen Qu
Journal:  Int J Endocrinol       Date:  2014-12-08       Impact factor: 3.257

7.  Duration of thyroid dysfunction correlates with all-cause mortality. the OPENTHYRO Register Cohort.

Authors:  Anne Sofie Laulund; Mads Nybo; Thomas Heiberg Brix; Bo Abrahamsen; Henrik Løvendahl Jørgensen; Laszlo Hegedüs
Journal:  PLoS One       Date:  2014-10-23       Impact factor: 3.240

8.  Is routine measurement of TSH in hospitalized patients necessary?

Authors:  Amir Bashkin; Eliran Yaakobi; Marina Nodelman; Ohad Ronen
Journal:  Endocr Connect       Date:  2018-03-23       Impact factor: 3.335

  8 in total

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