Are Thyroid Hormone Values Obtained in Hospitalized Elderly Patients Reproducible? - A Cohort Study

Area of Science:

• Geriatric Medicine
• Endocrinology
• Clinical Chemistry

Background:

• Hospitalization can influence thyroid-stimulating hormone (TSH) levels in elderly patients.
• The reliability of in-hospital TSH measurements for assessing true thyroid status is uncertain.

Purpose of the Study:

• To evaluate the correlation between TSH levels measured during hospitalization and subsequent ambulatory measurements in elderly patients.
• To determine the clinical utility of in-hospital TSH measurements for treatment decisions in hospitalized older adults.

Main Methods:

• Retrospective analysis of TSH levels from 562 elderly patients (≥65 years) hospitalized between 2012-2014.
• Correlation analysis between in-hospital TSH and ambulatory TSH (2-12 months post-discharge) in 198 patients.
• Identification of factors influencing TSH reproducibility through medical record review.

Main Results:

• In-hospital and ambulatory TSH levels showed significant correlation (r=0.677).
• Mean TSH difference was 0.65±2.36 mIU/l; >94% of cases differed by <2 mIU/l.
• In-hospital TSH values were concordant with ambulatory values, irrespective of blood pressure, hospitalization cause, or albumin levels.

Conclusions:

• TSH levels obtained during hospitalization are highly concordant with ambulatory values in elderly patients.
• In-hospital TSH measurements have clinical utility and can inform treatment decisions for hospitalized older adults.