Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patients
Abstract Background Low T3-(/T4-) syndrome, also known as non-thyroidal Illness Syndrome (NTIS) describes a decrease in free serum thyroid hormones without a concomitant increase in TSH, frequently observed in critically ill patients. However, whether NTIS is only a metabolic adaption to stress in c...
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-023-02015-1 |
| _version_ | 1797853596228780032 |
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| author | Natalie Krug Sven Bercker Thilo Busch Steffen Friese Nora Jahn Maria Theresa Voelker |
| author_facet | Natalie Krug Sven Bercker Thilo Busch Steffen Friese Nora Jahn Maria Theresa Voelker |
| author_sort | Natalie Krug |
| collection | DOAJ |
| description | Abstract Background Low T3-(/T4-) syndrome, also known as non-thyroidal Illness Syndrome (NTIS) describes a decrease in free serum thyroid hormones without a concomitant increase in TSH, frequently observed in critically ill patients. However, whether NTIS is only a metabolic adaption to stress in critically ill or plays a crucial role as an independent risk factor for ICU mortality, remains unknown. Our study aimed to evaluate NTIS as an independent risk factor for increased ICU mortality. Methods All patients admitted to the interdisciplinary intensive care unit (ICU) at the University Hospital of Leipzig between 2008 and 2014 were retrospectively analyzed for thyroidal function. Baseline data, information on additional thyroid function tests, disease progression, hospital and ICU length of stay (LOS) and patient outcome were retrospectively analyzed from the hospitals digital information system. For statistical evaluation, univariate analysis, matched pairs analysis and multivariate logistic regression were conducted. Results One thousand, seven hundred ninety patients were enrolled in the study, of which 665 showed NTIS. Univariate analysis revealed a positive association of NTIS with ICU- and hospital-LOS, need for mechanical ventilation, incidence of sepsis, acute respiratory distress syndrome, acute liver failure and increased ICU mortality. Results of matched pair analysis confirmed these findings. In multivariate logistic regression, NTIS was associated with an increased ICU-LOS, increased duration of mechanical ventilation, acute kidney injury and liver failure, but showed no independent association with increased ICU-mortality. Conclusion Duration of mechanical ventilation as well as incidence of acute kidney injury, sepsis and acute liver failure were detected as independent predictors of mortality in patients with NTIS. NTIS itself was no independent predictor of increased ICU-mortality. |
| first_indexed | 2024-04-09T19:53:19Z |
| format | Article |
| id | doaj.art-9350dec2640042f885b9333c2a3f19d3 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-09T19:53:19Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-9350dec2640042f885b9333c2a3f19d32023-04-03T05:38:23ZengBMCBMC Anesthesiology1471-22532023-03-012311910.1186/s12871-023-02015-1Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patientsNatalie Krug0Sven Bercker1Thilo Busch2Steffen Friese3Nora Jahn4Maria Theresa Voelker5Department of Anesthesiology and Critical Care Medicine, University Hospital LeipzigDepartment of Anesthesiology and Critical Care Medicine, University Hospital LeipzigDepartment of Anesthesiology and Critical Care Medicine, University Hospital LeipzigDepartment of Anesthesiology and Critical Care Medicine, University Hospital LeipzigDepartment of Anesthesiology and Critical Care Medicine, University Hospital LeipzigDepartment of Anesthesiology and Critical Care Medicine, University Hospital LeipzigAbstract Background Low T3-(/T4-) syndrome, also known as non-thyroidal Illness Syndrome (NTIS) describes a decrease in free serum thyroid hormones without a concomitant increase in TSH, frequently observed in critically ill patients. However, whether NTIS is only a metabolic adaption to stress in critically ill or plays a crucial role as an independent risk factor for ICU mortality, remains unknown. Our study aimed to evaluate NTIS as an independent risk factor for increased ICU mortality. Methods All patients admitted to the interdisciplinary intensive care unit (ICU) at the University Hospital of Leipzig between 2008 and 2014 were retrospectively analyzed for thyroidal function. Baseline data, information on additional thyroid function tests, disease progression, hospital and ICU length of stay (LOS) and patient outcome were retrospectively analyzed from the hospitals digital information system. For statistical evaluation, univariate analysis, matched pairs analysis and multivariate logistic regression were conducted. Results One thousand, seven hundred ninety patients were enrolled in the study, of which 665 showed NTIS. Univariate analysis revealed a positive association of NTIS with ICU- and hospital-LOS, need for mechanical ventilation, incidence of sepsis, acute respiratory distress syndrome, acute liver failure and increased ICU mortality. Results of matched pair analysis confirmed these findings. In multivariate logistic regression, NTIS was associated with an increased ICU-LOS, increased duration of mechanical ventilation, acute kidney injury and liver failure, but showed no independent association with increased ICU-mortality. Conclusion Duration of mechanical ventilation as well as incidence of acute kidney injury, sepsis and acute liver failure were detected as independent predictors of mortality in patients with NTIS. NTIS itself was no independent predictor of increased ICU-mortality.https://doi.org/10.1186/s12871-023-02015-1Critical illnessThyroid hormonesThyroid axisIntensive care |
| spellingShingle | Natalie Krug Sven Bercker Thilo Busch Steffen Friese Nora Jahn Maria Theresa Voelker Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patients BMC Anesthesiology Critical illness Thyroid hormones Thyroid axis Intensive care |
| title | Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patients |
| title_full | Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patients |
| title_fullStr | Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patients |
| title_full_unstemmed | Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patients |
| title_short | Non-thyroidal Illness Syndrome (NTIS) is no independent predictor for mortality in ICU patients |
| title_sort | non thyroidal illness syndrome ntis is no independent predictor for mortality in icu patients |
| topic | Critical illness Thyroid hormones Thyroid axis Intensive care |
| url | https://doi.org/10.1186/s12871-023-02015-1 |
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