Low Value of Thyroid Testing in the Pediatric Inpatient Setting.

Area of Science:

• Pediatric Endocrinology
• Clinical Chemistry
• Hospital Medicine

Background:

• Thyroid function tests (TFTs) are frequently performed in pediatric inpatients.
• Understanding the patterns and implications of inpatient thyroid testing is crucial for optimizing patient care.

Purpose of the Study:

• To determine the frequency of pediatric inpatient thyroid testing.
• To assess the rate of abnormal thyroid test results.
• To evaluate the impact of these results on patient management.

Main Methods:

• Retrospective study of pediatric hospital admissions from July 2015 to June 2016.
• Chart review of patients undergoing thyroid testing (TSH and/or FT4).
• Analysis of test results, clinical indications, and treatment changes.

Main Results:

• Thyroid testing occurred in 5.7% of hospitalizations, with combined TFTs being most common.
• 17.1% of tests showed abnormalities, often mild TSH elevations or borderline FT4 levels.
• Only 0.66% of patients were initiated on levothyroxine, with most abnormalities resolving on follow-up.

Conclusions:

• Pediatric inpatient thyroid testing is frequent, and abnormal results are common.
• Abnormalities detected do not typically indicate thyroid disease contributing to the hospitalization.
• Inpatient thyroid testing rarely identifies patients requiring urgent initiation of thyroid hormone therapy.