急诊住院患者甲状腺激素和非甲状腺性病态综合征对临床结局的预测能力研究OACSTPCD

Background Thyroid hormone(TH)is a metabolic indicator for judging the physical condition of emergency hospitalized patients,the relationship between triiodothyronine(T3)and the condition degree of emergency inpatients remains unclear.Objective To explore the correlation between T3 and the severity of condition and corresponding indicators in non-endocrinology emergency inpatients.Methods Clinical data about TH detected patients in emergency wards of Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine from January to June in 2021 were retrospectively included,then the patients were divided into NTIS group and non-NTIS group according to TH levels,and the hematological characteristics and TH levels of each group were analyzed.According to clinical diagnosis,the hospitalized patients were divided into infection group,non-infection group and impaired organ function group,in which the infection group was further divided into sepsis group,lung infection group,and local infection group.The thyroid function levels and low values in each group were evaluated,and the relationship between TH hormone levels with the risk of death of emergency inpatients was discussed.Results A total of 175 patients were enrolled,including 108 males and 67 females,with a mean age of(66.12±16.23)years.The incidence of NTIS in emergency ward was 62.29％,and T3 was the most sensitive indicator(56.00％),followed by FT3(46.86％).The risk of death in NTIS group was higher than that of non-NTIS group(28.44％vs 10.61％,P=0.006).The incidence of NTIS was high in sepsis group(83.33％)and organ dysfunction group(78.12％),and only 23.52％in non-infection group.The Receiver Operating Curve(ROC)and Area under the curve(AUC)showed T3 level was highly associated with the risk of death(AUC:0.750;95％CI:0.673-0.828;P＜0.001).Conclusion T3 is the most sensitive index for emergency patients,followed by FT3,and the decrease of T3 level has a certain predictive value for the risk of death.Thyroid function should be monitored in critically ill patients.