Non-thyroidal illness syndrome and isolated low triiodothyronine as prognostic markers in acute illness: a systematic review and meta-analysis.
Elisa Gatta, Virginia Maltese, Enrico Papini et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the relationship between thyroid hormone alterations and mortality in critically ill and cardiovascular patients. It included 22 studies, revealing that non-thyroidal illness syndrome (OR 3.19) and isolated low triiodothyronine (OR 2.93) are both significantly associated with increased mortality, although neither showed a clear superiority in prognostic performance.
Key findings
- Non-thyroidal illness syndrome was associated with mortality (OR 3.19, 95% CI 2.10-4.85).
- Isolated low triiodothyronine also showed a significant association with mortality (OR 2.93, 95% CI 2.04-4.20).
- Substantial heterogeneity was observed in both analyses (I²=67.5% for non-thyroidal illness syndrome, I²=63.8% for low triiodothyronine).
- No significant differences in effect size were found between the two definitions of thyroid dysfunction.
Why it matters
Understanding the prognostic implications of thyroid hormone alterations in critically ill patients can aid clinicians in risk stratification and management decisions. Both non-thyroidal illness syndrome and isolated low triiodothyronine serve as important markers of mortality risk.