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Thyroid hormone levels improve the prediction of mortality among patients admitted to the intensive care unit.

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Abstract

Objective

As hormones are strongly associated with mortality in critically ill patients, we investigated whether mortality prediction based on the Acute Physiology and Chronic Health Evaluation (APACHE) is improved by combining this score with hormone measurements.

Design and setting

Intensive care units in three hospitals

Patients and participants

113 patients admitted to.

Measurements

Within the first hour after ICU admission we measured total triiodothyronine, total thyroxine, free thyroxine, thyrotropin, cortisol, growth hormone, dehydroepiandrosterone, and prolactin levels and administered the APACHE. Patients were followed until they died or were discharged from the ICU.

Results

The best logistic regression model for ICU mortality included the APACHE score and thyroid-stimulating hormone and triiodothyronine levels. This model had an area under the receiver operating characteristic curve of 0.88, significantly higher than the APACHE score alone with 0.75. The model with hormone levels and APACHE score was also significantly better calibrated than the model with only the APACHE score.

Conclusions

The addition of thyroid hormones to the APACHE score improves the prediction of mortality for ICU patients

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Acknowledgements

We thank the participating patients and the medical and nursing staffs of the intensive care units in the Cayetano Heredia, Eduardo Rebagliati Martins and Arzobispo Loayza Hospitals. We also appreciate the assistance of the technical staff of the Endocrinology Laboratories of the Universidad Peruana Cayetano Heredia.

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Correspondence to Erick Chinga-Alayo.

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Chinga-Alayo, E., Villena, J., Evans, A.T. et al. Thyroid hormone levels improve the prediction of mortality among patients admitted to the intensive care unit.. Intensive Care Med 31, 1356–1361 (2005). https://doi.org/10.1007/s00134-005-2719-9

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  • DOI: https://doi.org/10.1007/s00134-005-2719-9

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