relationship between thyroid function and icu mortality a prospective observation study甲状腺功能和icu死亡率之间的关系一个前瞻性观察研究.pdfVIP

Wang et al. Critical Care 2012, 16:R11 /content/16/1/R11 RESEARCH Open Access Relationship between thyroid function and ICU mortality: a prospective observation study 1† 2† 1† 1 1* 2* Feilong Wang , Wenzhi Pan , Hairong Wang , Shuyun Wang , Shuming Pan and Junbo Ge Abstract Introduction: Although nonthyroidal illness syndrome is considered to be associated with adverse outcome in ICU patients, the performance of thyroid hormone levels in predicting clinical outcome in ICU patients is unimpressive. This study was conducted to assess the prognostic value of the complete thyroid indicators (free triiodothyronine (FT3), total triiodothyronine; free thyroxine, total thyroxine, thyroid-stimulating hormone and reverse triiodothyronine) in unselected ICU patients. Methods: A total of 480 consecutive patients without known thyroid diseases were screened for eligibility and followed up during their ICU stay. We collected each patient’s baseline characteristics, including the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and thyroid hormone, N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) levels. The primary outcome was ICU mortality. Potential predictors were analyzed for possible association with outcomes. We also evaluated the ability of thyroid hormones together with APACHE II score to predict ICU mortality by calculation of net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indices. Results: Among the thyroid hormone indicators, FT3 had the greatest power to predict ICU mortality, as suggested by the largest area under the curve (AUC) of 0.762 ± 0.028. The AUC for FT3 level was less