WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Dr. Ban Batea Khaleefah*, Dr. Ala'a Hussein Al-Taei, Dr. Marwah Mohammed Qasim and Dr. Marwan Almashhadani

ABSTRACT

Background: Critically ill patients typically present with low or normal plasma thyroxine, low plasma triiodothyronine (T3), increased plasma reverse T3 (rT3) concentrations, in the absence of a rise in thyrotropin (TSH). This constellation is referred to as nonthyroidal illness syndrome (NTI). It is long known that the severity of NTI is associated with risk of poor outcomes of critical illness. Aim of study: To evaluate the changes in the thyroid function, T3, T4 and TSH in critically ill patients in the intensive care unit and whether if it can predict the outcome of the critically ill patients. Patients and Methods: 40 patients were collected in a prospective cross sectional observational study, We recorded their baseline characteristics, acute physiology and chronic health evaluation (APACHE-II) score and thyroid function test weekly. thyroid dysfunction and ICU mortality were the primary outcomes. Results: Higher T3, T4, and TSH levels indicate a good prognosis, as they positively associated with lower mortality, and a higher discharge rate and vice versa. T3 levels decreases significantly in patients in ICU, while the decrease in T4, and TSH was not significant. APACHE II score had a better sensitivity and specificity than thyroid function test, and hence a better indicator of prognosis but the combination of both T3, and APACHE II score analysis had the highest prediction for death (R2= 0.34) than APACHE II score alone (R2=0.28). Conclusion: We observed a wide range change in thyroid hormones and thyrotropin, the combination of T3 levels and APACHE-II scores provided for a higher probability for predicting mortality in ICU patients.