High TSH and low T4 as prognostic markers in older patients

Autores
Mingote, Evelin; Meroño, Tomás; Rujelman, Rocío; Marquez, Alejandra; Fossati, Pia; Gurfinkiel, Mirta; Schnitman, Marta; Brites, Fernando Daniel; Faingold, Cristina; Brenta, Gabriela
Año de publicación
2012
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
OBJECTIVE: To examine the association between thyroid profile and morbidity/mortality (MM) in hospitalized older patients. DESIGN: This is a retrospective study of patients over the age of 60yr admitted to the Dr. Cesar Milstein Hospital between 2009 and 2010 and who had thyroid function tests (TFT). The patients were grouped as per their thyroid tests and their clinical characteristics and MM was associated with their TFT. High MM was defined as mortality, intensive care unit (ICU) requirement or prolonged hospital stay (>18 days, 75thpercentile), and mortality assessed during an 18-month follow-up period after their hospital discharge. RESULTS: Out of 2599 older patients admitted to our hospital, 7% had TFT performed for various reasons. The patients who had TFT were mostly women and presented in a more serious clinical condition compared to the rest of the patients. The patients were grouped as per their thyroid values as follows: 61% of them had a non-thyroidal illness, 25% were euthyroid, 7% had overt hyperthyroidism, 5% overt hypothyroidism and 1% had subclinical hyper- or hypothyroidism. The hypothyroid patients had a worse clinical outcome compared to the others. Patients with increased MM exhibited higher TSH and lower TT4 (p<0.005). Short-term MM (OR=2.0,95%CI=1.1-3.6, p<0.01) was associated with the decrease of TT4 adjusted by age, sex, T3 and TSH, while for long-term MM the increase in TSH (OR=1.6,95%CI 1.1-2.3, p<0.05) was also significant. CONCLUSION: Among hospitalized older patients who had TFT tests, low TT4 and high TSH were associated with a worse prognosis. We propose that TFT be used as an additional tool in assessing MM in elderly hospitalized patients.
Fil: Mingote, Evelin. Hospital "Dr. César Milstein"; Argentina
Fil: Meroño, Tomás. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Rujelman, Rocío. Hospital "Dr. César Milstein"; Argentina
Fil: Marquez, Alejandra. Hospital "Dr. César Milstein"; Argentina
Fil: Fossati, Pia. Hospital "Dr. César Milstein"; Argentina
Fil: Gurfinkiel, Mirta. Hospital "Dr. César Milstein"; Argentina
Fil: Schnitman, Marta. Hospital "Dr. César Milstein"; Argentina
Fil: Brites, Fernando Daniel. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Faingold, Cristina. Hospital "Dr. César Milstein"; Argentina
Fil: Brenta, Gabriela. Hospital "Dr. César Milstein"; Argentina
Materia
Elderly patients
Hypothyroidism
Hospitalization
Non-thyroidal illness
Thyroid hormones
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/12867
Acceder
id CONICETDig_0349c804e59ab1a62917c814b4bf312e
oai_identifier_str oai:ri.conicet.gov.ar:11336/12867
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling High TSH and low T4 as prognostic markers in older patientsMingote, EvelinMeroño, TomásRujelman, RocíoMarquez, AlejandraFossati, PiaGurfinkiel, MirtaSchnitman, MartaBrites, Fernando DanielFaingold, CristinaBrenta, GabrielaElderly patientsHypothyroidismHospitalizationNon-thyroidal illnessThyroid hormoneshttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3OBJECTIVE: To examine the association between thyroid profile and morbidity/mortality (MM) in hospitalized older patients. DESIGN: This is a retrospective study of patients over the age of 60yr admitted to the Dr. Cesar Milstein Hospital between 2009 and 2010 and who had thyroid function tests (TFT). The patients were grouped as per their thyroid tests and their clinical characteristics and MM was associated with their TFT. High MM was defined as mortality, intensive care unit (ICU) requirement or prolonged hospital stay (>18 days, 75thpercentile), and mortality assessed during an 18-month follow-up period after their hospital discharge. RESULTS: Out of 2599 older patients admitted to our hospital, 7% had TFT performed for various reasons. The patients who had TFT were mostly women and presented in a more serious clinical condition compared to the rest of the patients. The patients were grouped as per their thyroid values as follows: 61% of them had a non-thyroidal illness, 25% were euthyroid, 7% had overt hyperthyroidism, 5% overt hypothyroidism and 1% had subclinical hyper- or hypothyroidism. The hypothyroid patients had a worse clinical outcome compared to the others. Patients with increased MM exhibited higher TSH and lower TT4 (p<0.005). Short-term MM (OR=2.0,95%CI=1.1-3.6, p<0.01) was associated with the decrease of TT4 adjusted by age, sex, T3 and TSH, while for long-term MM the increase in TSH (OR=1.6,95%CI 1.1-2.3, p<0.05) was also significant. CONCLUSION: Among hospitalized older patients who had TFT tests, low TT4 and high TSH were associated with a worse prognosis. We propose that TFT be used as an additional tool in assessing MM in elderly hospitalized patients.Fil: Mingote, Evelin. Hospital "Dr. César Milstein"; ArgentinaFil: Meroño, Tomás. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Rujelman, Rocío. Hospital "Dr. César Milstein"; ArgentinaFil: Marquez, Alejandra. Hospital "Dr. César Milstein"; ArgentinaFil: Fossati, Pia. Hospital "Dr. César Milstein"; ArgentinaFil: Gurfinkiel, Mirta. Hospital "Dr. César Milstein"; ArgentinaFil: Schnitman, Marta. Hospital "Dr. César Milstein"; ArgentinaFil: Brites, Fernando Daniel. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Faingold, Cristina. Hospital "Dr. César Milstein"; ArgentinaFil: Brenta, Gabriela. Hospital "Dr. César Milstein"; ArgentinaHellenic Endocrine Society2012-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/12867Mingote, Evelin; Meroño, Tomás; Rujelman, Rocío; Marquez, Alejandra; Fossati, Pia; et al.; High TSH and low T4 as prognostic markers in older patients; Hellenic Endocrine Society; Hormone; 11; 3; 7-2012; 350-3551109-3099enginfo:eu-repo/semantics/altIdentifier/url/http://www.hormones.gr/814/article/article.htmlinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-10-22T12:11:30Zoai:ri.conicet.gov.ar:11336/12867instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-10-22 12:11:31.214CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv High TSH and low T4 as prognostic markers in older patients
title High TSH and low T4 as prognostic markers in older patients
spellingShingle High TSH and low T4 as prognostic markers in older patients
Mingote, Evelin
Elderly patients
Hypothyroidism
Hospitalization
Non-thyroidal illness
Thyroid hormones
title_short High TSH and low T4 as prognostic markers in older patients
title_full High TSH and low T4 as prognostic markers in older patients
title_fullStr High TSH and low T4 as prognostic markers in older patients
title_full_unstemmed High TSH and low T4 as prognostic markers in older patients
title_sort High TSH and low T4 as prognostic markers in older patients
dc.creator.none.fl_str_mv Mingote, Evelin
Meroño, Tomás
Rujelman, Rocío
Marquez, Alejandra
Fossati, Pia
Gurfinkiel, Mirta
Schnitman, Marta
Brites, Fernando Daniel
Faingold, Cristina
Brenta, Gabriela
author Mingote, Evelin
author_facet Mingote, Evelin
Meroño, Tomás
Rujelman, Rocío
Marquez, Alejandra
Fossati, Pia
Gurfinkiel, Mirta
Schnitman, Marta
Brites, Fernando Daniel
Faingold, Cristina
Brenta, Gabriela
author_role author
author2 Meroño, Tomás
Rujelman, Rocío
Marquez, Alejandra
Fossati, Pia
Gurfinkiel, Mirta
Schnitman, Marta
Brites, Fernando Daniel
Faingold, Cristina
Brenta, Gabriela
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Elderly patients
Hypothyroidism
Hospitalization
Non-thyroidal illness
Thyroid hormones
topic Elderly patients
Hypothyroidism
Hospitalization
Non-thyroidal illness
Thyroid hormones
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv OBJECTIVE: To examine the association between thyroid profile and morbidity/mortality (MM) in hospitalized older patients. DESIGN: This is a retrospective study of patients over the age of 60yr admitted to the Dr. Cesar Milstein Hospital between 2009 and 2010 and who had thyroid function tests (TFT). The patients were grouped as per their thyroid tests and their clinical characteristics and MM was associated with their TFT. High MM was defined as mortality, intensive care unit (ICU) requirement or prolonged hospital stay (>18 days, 75thpercentile), and mortality assessed during an 18-month follow-up period after their hospital discharge. RESULTS: Out of 2599 older patients admitted to our hospital, 7% had TFT performed for various reasons. The patients who had TFT were mostly women and presented in a more serious clinical condition compared to the rest of the patients. The patients were grouped as per their thyroid values as follows: 61% of them had a non-thyroidal illness, 25% were euthyroid, 7% had overt hyperthyroidism, 5% overt hypothyroidism and 1% had subclinical hyper- or hypothyroidism. The hypothyroid patients had a worse clinical outcome compared to the others. Patients with increased MM exhibited higher TSH and lower TT4 (p<0.005). Short-term MM (OR=2.0,95%CI=1.1-3.6, p<0.01) was associated with the decrease of TT4 adjusted by age, sex, T3 and TSH, while for long-term MM the increase in TSH (OR=1.6,95%CI 1.1-2.3, p<0.05) was also significant. CONCLUSION: Among hospitalized older patients who had TFT tests, low TT4 and high TSH were associated with a worse prognosis. We propose that TFT be used as an additional tool in assessing MM in elderly hospitalized patients.
Fil: Mingote, Evelin. Hospital "Dr. César Milstein"; Argentina
Fil: Meroño, Tomás. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Rujelman, Rocío. Hospital "Dr. César Milstein"; Argentina
Fil: Marquez, Alejandra. Hospital "Dr. César Milstein"; Argentina
Fil: Fossati, Pia. Hospital "Dr. César Milstein"; Argentina
Fil: Gurfinkiel, Mirta. Hospital "Dr. César Milstein"; Argentina
Fil: Schnitman, Marta. Hospital "Dr. César Milstein"; Argentina
Fil: Brites, Fernando Daniel. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Faingold, Cristina. Hospital "Dr. César Milstein"; Argentina
Fil: Brenta, Gabriela. Hospital "Dr. César Milstein"; Argentina
description OBJECTIVE: To examine the association between thyroid profile and morbidity/mortality (MM) in hospitalized older patients. DESIGN: This is a retrospective study of patients over the age of 60yr admitted to the Dr. Cesar Milstein Hospital between 2009 and 2010 and who had thyroid function tests (TFT). The patients were grouped as per their thyroid tests and their clinical characteristics and MM was associated with their TFT. High MM was defined as mortality, intensive care unit (ICU) requirement or prolonged hospital stay (>18 days, 75thpercentile), and mortality assessed during an 18-month follow-up period after their hospital discharge. RESULTS: Out of 2599 older patients admitted to our hospital, 7% had TFT performed for various reasons. The patients who had TFT were mostly women and presented in a more serious clinical condition compared to the rest of the patients. The patients were grouped as per their thyroid values as follows: 61% of them had a non-thyroidal illness, 25% were euthyroid, 7% had overt hyperthyroidism, 5% overt hypothyroidism and 1% had subclinical hyper- or hypothyroidism. The hypothyroid patients had a worse clinical outcome compared to the others. Patients with increased MM exhibited higher TSH and lower TT4 (p<0.005). Short-term MM (OR=2.0,95%CI=1.1-3.6, p<0.01) was associated with the decrease of TT4 adjusted by age, sex, T3 and TSH, while for long-term MM the increase in TSH (OR=1.6,95%CI 1.1-2.3, p<0.05) was also significant. CONCLUSION: Among hospitalized older patients who had TFT tests, low TT4 and high TSH were associated with a worse prognosis. We propose that TFT be used as an additional tool in assessing MM in elderly hospitalized patients.
publishDate 2012
dc.date.none.fl_str_mv 2012-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/12867
Mingote, Evelin; Meroño, Tomás; Rujelman, Rocío; Marquez, Alejandra; Fossati, Pia; et al.; High TSH and low T4 as prognostic markers in older patients; Hellenic Endocrine Society; Hormone; 11; 3; 7-2012; 350-355
1109-3099
url http://hdl.handle.net/11336/12867
identifier_str_mv Mingote, Evelin; Meroño, Tomás; Rujelman, Rocío; Marquez, Alejandra; Fossati, Pia; et al.; High TSH and low T4 as prognostic markers in older patients; Hellenic Endocrine Society; Hormone; 11; 3; 7-2012; 350-355
1109-3099
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://www.hormones.gr/814/article/article.html
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Hellenic Endocrine Society
publisher.none.fl_str_mv Hellenic Endocrine Society
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1846782507049025536
score 12.982451

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