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Relevance of TSH evaluation in elderly in-patients with non-thyroidal illness.
Rosenfarb, J; Sforza, N; Rujelman, R; Morosan Allo, Y; Parisi, C; Blanc, E; Frigerio, C; Fossati, P; Caruso, D; Faingold, C; Meroño, T; Brenta, G.
Afiliação
  • Rosenfarb J; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Sforza N; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Rujelman R; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Morosan Allo Y; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Parisi C; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Blanc E; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Frigerio C; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Fossati P; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Caruso D; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Faingold C; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina.
  • Meroño T; Depto. de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina.
  • Brenta G; Thyroid Unit, Department of Endocrinology and Metabolism, Unidad Asistencial Dr. César Milstein/PAMI-INSSJP, La Rioja 951, (1221), Buenos Aires, Argentina. gbrenta@gmail.com.
J Endocrinol Invest ; 42(6): 667-671, 2019 Jun.
Article em En | MEDLINE | ID: mdl-30367433
BACKGROUND: Non-thyroidal illness (NTI) is frequent in hospitalized patients. Its recovery is characterized by a raise in TSH levels. However, the clinical significance of high TSH levels at admission in hospitalized elderly patients with NTI remains uncertain. AIM: To explore the relevance of baseline TSH evaluation in hospitalized elderly patients with NTI. METHODS: We examined the participants with NTI (n = 123) from our previous study (Sforza, 2017). NTI was defined as: low T3 (< 80 ng/dL) and normal or low total T4 in the presence of TSH values between 0.1 and 6.0 mU/L. Thyroid function tests were performed on day 1 and day 8 of the hospital stay. Positive TSH changes (+ ΔTSH) were considered when the day-8 TSH value increased more than the reference change value for TSH (+ 78%). Multiple logistic regression was used to evaluate the independent association of baseline TSH, sex, clinical comorbidities (by ACE-27) and medications with + ΔTSH. RESULTS: Out of 123 patients (77 ± 8 years, 52% female), 34 showed a + ΔTSH. These patients had a lower TSH at admission (p < 0.001) and intra-hospital mortality (p = 0.003) than the others. In multiple logistic regression, TSH > 2.11 mU/L at baseline was associated with reduced odds to show + ΔTSH [odds ratio (95 CI) 0.29 (0.11-0.75); p = 0.011] in a model adjusted by age, sex and ACE-27. DISCUSSION: Inappropriately higher TSH levels at admission in hospitalized elderly patients were associated with a reduced ability to raise their TSH levels later on. The present results confront the idea that TSH levels at admission are irrelevant in this clinical context.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glândula Tireoide / Envelhecimento / Hormônio Liberador de Tireotropina / Hospitalização / Tempo de Internação Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Endocrinol Invest Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Argentina País de publicação: Itália
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glândula Tireoide / Envelhecimento / Hormônio Liberador de Tireotropina / Hospitalização / Tempo de Internação Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: J Endocrinol Invest Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Argentina País de publicação: Itália