Angelousi AG, Karageorgopoulos DE, Kapaskelis AM, Falagas ME.; Eur J Endocrinol. 2010 Nov 15.
Introduction. The severity of critical illness is associated with various patterns of thyroid hormone abnormalities. We sought to evaluate whether the outcome of patients with, specifically, sepsis or septic shock is associated with the thyroid function tests obtained at diagnosis or admission in the intensive care unit (ICU).
Methods. We performed a systematic review of relevant studies by searching PubMed.
Results. We included 9 studies, that all had a prospective cohort design. Seven involved children or neonates and 2 involved adults. Mortality was the outcome evaluated in 8 studies, while the length of ICU stay was evaluated in the remaining study. In univariate analysis, 6 of the 9 included studies showed that, either the free or total, triiodothyronine or thyroxine were lower in the group of patients with sepsis or septic shock who had unfavorable outcome compared with those who had favorable outcome. Two other studies showed higher thyroid-stimulating hormone values in the group of patients with unfavorable outcome. No significant relevant findings were noted in the remaining study. Regarding the correlation of sepsis prognostic scoring systems with thyroid function tests, the 3 studies that provided specific relevant data showed variable findings.
Discussion. Most of the relevant studies identified favor the concept that decreased thyroid function at baseline might be associated with a worse outcome in patients with sepsis or septic shock. Although these findings are not consistent, the role of thyroid function in affecting or merely predicting the outcome of sepsis or septic shock merits further investigation.
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