Thyroid hormone levels predict mortality in intensive care patients with cirrhosis

Mortality rates of intensive care patients are quite high. The aim of this study was to determine the availability of thyroid function tests and predictive scoring systems on the outcome of cirrhotic patients admitted to the intensive care unit.

A total of 106 patients were included in the final analysis, of which 32 were men (30.2%) and 74 were women (69.8%). Predictors of mortality that were investigated include acute physiology and chronic health evaluation (APACHE II), model for end-stage liver disease (MELD), Child-Turcotte-Pugh (CTP) and sequential organ failure assessment (SOFA) scores and thyroid function tests including free triiodo-L-thryronin (fT3), free tetraiodothyronine/thyroxine (fT4) and thyroid-stimulating hormone/thyrotropin (TSH) levels.

High APACHE II, MELD, CTP and SOFA score and suppression of fT3 were all found to be associated with higher mortality in our intensive care patients who have cirrhosis (P < 0.001). Suppression of fT3 was also found to be reciprocally correlated with high APACHE II, MELD, CTP and SOFA scores (P < 0.001). fT4 had also reciprocal correlation with APACHE II, MELD, CTP and mortality. There is no correlation between TSH levels and predictive scores or mortality.

Calculation of APACHE II, MELD, CTP and SOFA scores and measurement of fT3 and fT4 levels may all be useful as predictors of mortality in intensive care patients who have cirrhosis.