Background and Aim: Sepsis is a life-threatening issue that happens when the body’s immune system has an extreme response to an infection, causing organ dysfunction. Critical illness and sepsis are difficult to treat with increasing age because of the poor adaptive physiological system as age progresses. The study tries to identify prognostic markers among thyroid hormones for post-surgical critically ill subjects, who have sepsis, to improve the outcome of patients with increasing age.
Methods: Post-surgical critically ill patients with sepsis
were recruited in the study. Key features of the critically ill patient are
severe respiratory, cardiovascular or neurological derangement, often in
combination, reflected in abnormal physiological observations. Free
triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone
(TSH) were estimated by ARCHITECT immunoassay kits in 127 post-surgical
critically ill patients with sepsis. Sequential Organ Failure Assessment (SOFA)
score was recorded for each patient.
Results: The FT3, FT4 and TSH levels decreased and SOFA
scores increased with increasing age. Thyroid markers were significantly
inversely correlated with age (for FT4 r= -0.616, p<0.0001 and for TSH r=
-0.453, p<0.0001), with the strongest correlation between FT3 and age
(r=0.674, p<0.0001). A positive correlation was observed between SOFA score
and age (r=0.577, p<0.0001). FT3 decreases SOFA and age increase from
improved prognosis to worst prognosis (p<0.0001). The patients whose
condition improved were mostly young as compared to the no change group, deteriorated
group and expired group.
Conclusions: FT3 surfaced as a prominent prognostic marker
that may be used in predicting the prognosis of post-surgical critically ill
geriatric patients with sepsis.
Author (s) Details
Pallavi Rain
Department of Biochemistry, Santosh Medical College and Hospital, Santosh
Deemed to be University, Ghaziabad, Uttar Pradesh, India.
Jyoti Batra
Department of Biochemistry, Santosh Medical College and Hospital, Santosh
Deemed to be University, Ghaziabad, Uttar Pradesh, India.
Ankit Batra
Department of Orthopedics, School of Medical Sciences, Sharda University,
Greater Noida, Uttar Pradesh, India.
Aarushi Batra
Medical Intern, LLRM Medical College, Meerut, India.
Please see the book here:- https://doi.org/10.9734/bpi/prrat/v3/450
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