Total tithriiodothyronine level associated with disease severity for patients with emergent status

Abstract

Abstract Thyroid hormone is a metabolic indicator to evaluate the physical condition of emergency hospitalized patients, while the relationship between total triiodothyronine and the severity of emergency inpatients is still unclear. To explore the thyroid function levels of inpatients in emergency ward and the status of combined Nonthyroidal illness syndrome (NTIS), and to emphasize the importance of thyroid hormone examination for non-endocrinology inpatients. According to thyroid function of inpatients in emergency ward, they were divided into NTIS group and non-NTIS group, the hematological characteristics and TH levels of each group were analyzed. Based on clinical diagnosis, the hospitalized patients were divided into three major groups, namely infection group, non-infection group and impaired organ function group. Among them, infection group was further divided into sepsis group, lung infection group and local infection group, altogether five groups. The NTIS incidence and thyroid function levels in each group were evaluated, and the correlation between thyroid function, inflammatory factors and nutritional indicators were investigated. The inpatient rate in emergency ward complicated with NTIS was 62.29 %, T3 was the most sensitive index of NTIS, followed by FT3. Compared to non-NTIS group, the NTIS group had an increased risk of death. The sepsis group and impaired organ function group had the highest rates of complicated NTIS, reaching 83.33 % and 78.12 % respectively, compared with other clinical diagnosis groups. Spearman's correlation analysis implied T3/T4/FT3 levels were positively correlated with ALb and PLT (except T4), and negatively correlated with CRP, D-Dimer, IL-6 and Fer. FT4 wasn’t correlated with above indicators, and TSH was only negatively correlated with CRP and IL-6. T3 is the most sensitive indicator of the inpatient conditions, followed by FT3. When diseases progress to severe, T4 or FT4 decreases. In critically ill patients, attention should be paid to monitoring thyroid function, especially total T3 and T4 levels.