Liu Jinliang, Wu Xuejie, Lu Fang, Zhao Lifang, Shi Lingxian, Xu Feng
Department of Infectious Diseases, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Respiratory Medicine, Quzhou People's Hospital, Quzhou, China.
Sci Rep. 2016 Mar 1;6:22271. doi: 10.1038/srep22271.
Low T3 syndrome was previously reported to be linked to poor clinical outcomes in critically ill patients. The aim of this study was to evaluate the predictive power of low T3 syndrome for clinical outcomes in patients with community-acquired pneumonia (CAP). Data for 503 patients were analyzed retrospectively, and the primary end point was 30-day mortality. The intensive care unit (ICU) admission rate and 30-day mortality were 8.3% and 6.4% respectively. The prevalence of low T3 syndrome differed significantly between survivors and nonsurvivors (29.1% vs 71.9%, P < 0.001), and low T3 syndrome was associated with a remarkable increased risk of 30-day mortality and ICU admission in patients with severe CAP. Multivariate logistic regression analysis produced an odds ratio of 2.96 (95% CI 1.14-7.76, P = 0.025) for 30-day mortality in CAP patients with low T3 syndrome. Survival analysis revealed that the survival rate among CAP patients with low T3 syndrome was lower than that in the control group (P < 0.01). Adding low T3 syndrome to the PSI and CURB-65 significantly increased the areas under the ROC curves for predicting ICU admission and 30-day mortality. In conclusion, low T3 syndrome is an independent risk factor for 30-day mortality in CAP patients.
先前有报道称低T3综合征与危重症患者不良临床结局相关。本研究旨在评估低T3综合征对社区获得性肺炎（CAP）患者临床结局的预测能力。对503例患者的数据进行回顾性分析，主要终点为30天死亡率。重症监护病房（ICU）入住率和30天死亡率分别为8.3%和6.4%。低T3综合征的患病率在幸存者和非幸存者之间存在显著差异（29.1%对71.9%，P < 0.001），并且低T3综合征与重症CAP患者30天死亡率和ICU入住风险显著增加相关。多因素逻辑回归分析显示，低T3综合征的CAP患者30天死亡率的比值比为2.96（95%可信区间1.14 - 7.76，P = 0.025）。生存分析表明，低T3综合征的CAP患者生存率低于对照组（P < 0.01）。将低T3综合征纳入PSI和CURB - 65可显著增加预测ICU入住和30天死亡率的ROC曲线下面积。总之，低T3综合征是CAP患者30天死亡率的独立危险因素。
