Biegelmeyer Erika, Scanagata Iury, Alves Laura, Reveilleau Murilo, Schwengber Fernando Pereira, Wajner Simone Magagnin
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Internal Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Endocr Connect. 2021 Jul 28;10(8):852-860. doi: 10.1530/EC-21-0080.
Low T3 syndrome refers to a set of thyroid hormone metabolism alterations present in the disease state. A correlation between low T3 and poor clinical outcomes in the intensive care unit is more established. Nonetheless, studies on non-critically ill patients are few and controversial.
To evaluate the prevalence and predictive value of low T3 levels on 30-day and 6-month mortality in non-critically ill patients. Secondary outcomes evaluated the length of hospital stay, overall mortality, and hospital readmission.
Prospective cohort study.
A total of 345 consecutive patients from the Internal Medicine ward of a tertiary hospital in southern Brazil were included and followed from October 2018 to April 2019 (6 months). Levels of total serum T3 were measured weekly, from admission to discharge, and correlated with 30-day and 6-month mortality.
Prevalence of low T3 was 36.6%. Low T3 levels were associated with higher 30-day hospital mortality (15.1% vs 4.1%, P < 0.001) and higher 6-month overall mortality (31.7% vs 13.2%, P < 0.001). Total serum T3 at admission was an independent predictor of 30-day hospital mortality.
Low T3 levels are a prevalent condition among non-critically ill patients, and this condition is associated with poor clinical outcomes in this population. Total serum T3 levels, alone or in association with other predictive scores, were demonstrated to be an easy and valuable tool for risk stratification and should be further employed in this setting.
低T3综合征是指疾病状态下出现的一组甲状腺激素代谢改变。低T3与重症监护病房不良临床结局之间的相关性已得到更充分的确立。尽管如此，针对非危重症患者的研究较少且存在争议。
评估非危重症患者低T3水平对30天和6个月死亡率的患病率及预测价值。次要结局评估住院时间、总死亡率和再入院情况。
前瞻性队列研究。
纳入巴西南部一家三级医院内科病房的345例连续患者，于2018年10月至2019年4月（6个月）进行随访。从入院到出院每周测量血清总T3水平，并与30天和6个月死亡率相关联。
低T3的患病率为36.6%。低T3水平与30天住院死亡率较高（15.1%对4.1%，P<0.001）和6个月总死亡率较高（31.7%对13.2%，P<0.001）相关。入院时的血清总T3是30天住院死亡率的独立预测因素。
低T3水平在非危重症患者中普遍存在，且这种情况与该人群的不良临床结局相关。血清总T3水平单独或与其他预测评分联合，被证明是一种简单且有价值的风险分层工具，应在该环境中进一步应用。
