The impact of thyroid hormone levels and APACHE II scores on the clinical outcome in critically ill patients | [Anaesthesia, Pain and Intensive Care • 2024]

Author(s):

1. Rio Wironegoro: Department of Internal Medicine, Faculty of Medicine, Airlangga University,Surabaya-Indonesia Jl. Prof. Dr. Moestopo 47 Surabaya,Indonesia

2. Christian Julio Suhardi: Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University, Surabaya-Indonesia Jl. Prof. Dr. Moestopo 47 Surabaya, Indonesia

3. Maulydia: Department of Anesthesiology and Reanimation, Faculty of Medicine, Airlangga University,Surabaya-Indonesia Jl. Prof. Dr. Moestopo 47 Surabaya,Indonesia

4. Sony Wibisono: Department of Internal Medicine, Faculty of Medicine, Airlangga University,Surabaya-Indonesia Jl. Prof. Dr. Moestopo 47 Surabaya,Indonesia

5. Soebagijo Adi: Department of Internal Medicine, Faculty of Medicine, Airlangga University,Surabaya-Indonesia Jl. Prof. Dr. Moestopo 47 Surabaya,Indonesia

6. Rahmaweni Rahmaweni: Department of Epidemiology, Biostatistics, Population Studies and Health Promotion, Faculty of Public Health, Campus C Mulyorejo-Airlangga University,Surabaya-,Indonesia

Abstract:

Background & objective: Thyroid hormone levels are often raised during stress and acute illness. APACHE II score has been linked to adverse outcome after severe disease. We analyzed the impact of the level of free triiodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormones (TSH), and APACHE II scores on the outcome of critically ill patients admitted to Intensive Care Unit (ICU). Methodology: A cohort prospective study was conducted on critically ill patients in the ICU. Patients' baseline data, thyroid hormone levels, including fT3, fT4, TSH, and APACHE II score within 24 h of admission were compared between 30-day survivors and non-survivors. Multivariate Cox proportional hazards regression analysis was conducted to assess the risk factors for mortality. fT3Non-survivors were significantly older than survivors (55.81 ± 12.61 vs 41.40 ± 11.40, P = 0.003). The APACHE II score was higher in non-survivors (25.88 ± 9.28 vs 22.13 ± 10.42, P = 0.299). Thyroid hormone levels showed no significant difference between the two groups. The area under the receiver-operating curve for APACHE II was 0.610 (0.403-0.818), and for fT3 was 0.523 (0.311-0.735). Conclusion: Although there was no significant difference in thyroid hormone levels between the survivors and nonsurvivors, the results of this study show that low fT3 levels and high APACHE II scores had a more significant association with adverse clinical outcomes in critically ill patients.

Page(s): 416-422

DOI: 10.35975/apic.v28i3.2478

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 28, Issue: 3, Year: 2024

Keywords:

critically ill , Mortality , APACHE II score , fT4 level , fT3 level

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