Lower Free T3 Levels Linked to Poorer Outcomes in Chronic Obstructive Pulmonary Disease Patients with Acute Hypercapnic Respiratory Failure

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dc.authorscopusid22133297600en_US
dc.authorscopusid36159707800en_US
dc.contributor.authorAkbas, Tuerkay
dc.contributor.authorGunes, Harun
dc.date.accessioned2024-08-23T16:03:42Z
dc.date.available2024-08-23T16:03:42Z
dc.date.issued2024en_US
dc.departmentDüzce Üniversitesien_US
dc.description.abstractAim of the Study Non-thyroidal illness syndrome (NTIS) is often observed in critically ill patients. This study aimed to examine thyroid hormone changes in patients with chronic obstructive pulmonary disease (COPD) experiencing acute hypercapnic respiratory failure (AHRF) and to evaluate the impact of these alterations on clinical outcomes.Materials and Methods This retrospective investigation involved 80 COPD patients (age 71.5 +/- 9.5 years; 57.5% male) admitted to the intensive care unit (ICU) due to AHRF. NTIS was identified when free triiodothyronine (fT3) levels were below the lower limit, and thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels were within the normal range or below the lower limits.Results NTIS was detected in 63.7% of the patients. Decreased fT3 levels were found in 36.3% of the patients, reduced T4 levels in 33.8%, and diminished TSH levels in 15%. Patients with low fT3 levels exhibited elevated C-reactive protein levels, white blood cell counts, and APACHE II scores, necessitated vasopressor infusion more frequently during their ICU stay, and had increased mortality. The in-hospital mortality rate was 28.8%. Logistic regression analysis revealed that fT3 level (odds ratio [OR]., 0.271; 95% confidence interval [CI]., 0.085-0.865; p=0.027), APACHE II score (OR, 1.155; 95% CI, 1.041-1.282; p=0.007), and vasopressor use (OR, 5.426; 95% CI, 1.439-20.468; p=0.013) were crucial predictors of in-hospital mortality.Conclusions A high prevalence of NTIS is observed in COPD patients with AHRF, with low fT3 levels frequently observed. The presence of lower levels of fT3 is associated with a greater severity of the disease and a significant prognostic indicator.en_US
dc.identifier.doi10.2478/jccm-2024-0002
dc.identifier.endpage63en_US
dc.identifier.issn2393-1809
dc.identifier.issn2393-1817
dc.identifier.issue1en_US
dc.identifier.pmid39108803en_US
dc.identifier.scopus2-s2.0-85200331765en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage56en_US
dc.identifier.urihttps://doi.org/10.2478/jccm-2024-0002
dc.identifier.urihttps://hdl.handle.net/20.500.12684/13878
dc.identifier.volume10en_US
dc.identifier.wosWOS:001252677500006en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSciendoen_US
dc.relation.ispartofJournal of Critical Care Medicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjecthypercapnic respiratory failureen_US
dc.subjectcritical illnessen_US
dc.subjectfree triiodothyronineen_US
dc.subjectmortality predictoren_US
dc.subjectnon-thyroidal illness syndromeen_US
dc.subjectNonthyroidal Illness Syndromeen_US
dc.subjectThyroid-Functionen_US
dc.subjectMechanismsen_US
dc.subjectPredictoren_US
dc.titleLower Free T3 Levels Linked to Poorer Outcomes in Chronic Obstructive Pulmonary Disease Patients with Acute Hypercapnic Respiratory Failureen_US
dc.typeArticleen_US

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