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J Clin Endocrinol Metab. 2013 Dec;98(12):4683-90. doi: 10.1210/jc.2012-3849. Epub 2013 Oct 30.

Thyroid function tests and mortality in aged hospitalized patients: a 7-year prospective observational study.

Author information

1
Department of Endocrinology, Hospital Ramón y Cajal, Ctra. de colmenar, Km 9,100, 28034 Madrid, Spain. piglo65@gmail.com.

Abstract

CONTEXT:

Several alterations in thyroid function test (TFT) results have been associated with mortality in elderly patients.

OBJECTIVE:

Our aim was to investigate the relationship between TFT results and all-cause and cardiovascular (CV) mortality in aged hospitalized patients.

DESIGN:

A 7-year prospective observational study was conducted. TFTs were performed at hospital admission, and mortality was registered in the follow-up period.

PATIENTS:

Participants were 404 patients aged >65 years admitted to the Department of Geriatrics, Hospital General, Segovia, Spain, for any reason during 2005.

MAIN OUTCOME MEASURES:

The study evaluated the association between TFT results and mortality from all causes and CV diseases.

METHODS:

TSH, free T₄, and free T₃ (FT₃) were measured on the first day of admission. In-hospital and total survival times, number of deaths, and all-cause and CV mortality were registered until the census date on January 1, 2012.

RESULTS:

During the study, 323 patients (80%) died. Kaplan-Meier analysis showed that median survival time for all-cause mortality was significantly lower in patients in the first tertile of serum FT₃, in the first tertile of TSH, and in the first tertile of serum free T₄ concentrations. Multivariate adjusted Cox regression analysis showed that the history of cancer (hazard ratio, 1.60; 95% confidence interval, 1.12-2.28; P = .009), age (1.03; 1.01-1.06; P = .003), and FT₃ levels (0.72; 0.63-0.84; P < .001) were significant factors related to all-cause mortality. The cause of death was known in 202 patients. Of this group, 61 patients (30.2%) died of CV disease. Patients in the first tertile of TSH and FT₃ exhibited a significant higher mortality due to CV disease. In the adjusted Cox regression analysis, FT₃ was a significant predictor of CV mortality (0.76; 0.63-0.91; P = .004).

CONCLUSIONS:

Alterations in TFT results during hospitalization are associated with long-term mortality in elderly patients. In particular, low FT₃ levels are significantly related to all-cause and CV mortality.

PMID:
24171920
DOI:
10.1210/jc.2012-3849
[Indexed for MEDLINE]

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