The Value of Non Thyroidal Illness Syndrome as A Prognostic Marker in Elderly Egyptian Patients Admitted to The Intensive Care Unit
Prof. Dr. Motassem Salah Amer, Dr. Tamer Mohammed Farid, Menna-t-Allah Abdel GhanyShawkat Mohammed, Prof. Dr. Randa Abdel WahabRedaMabrouk
Aim: determination of the prognostic value of the presence of nonthyroidal illness in critically ill elderly
Methods: This was an observational cross-sectional study. One hundred elderly patients were included
from the Geriatric Intensive Care Unit in Ain Shams University Hospital. Each patient underwent clinical assessment of
severity of illness using APACHE II score, and measurement of thyroid stimulating hormone, free T3, free T4and high
sensitivity C reactive protein.
Results: Results revealed that there was a high prevalence of nonthyroidal illness syndrome among critically ill elderly
(72%) and were higher among female patients (60%). The prognosis of patients with NTIS was worse than patients with
normal thyroid function although this was not statistically significant.
The alteration in thyroid function tests increased and the hs-CRP increased which suggested that NTIS was a sign of
severity of the critical illness. Also the addition of FT3 values to the APACHE II score increased its sensitivity in predicting the outcome in the critically ill elderly.
Conclusion: Overall NTIS was inconclusive alone as an index of the prognosis in patients with NTIS in patients admitted to ICU, but the addition of thyroid hormones to the APACHE II score improved the sensitivity in prediction of mortality for ICU patients.