Effect of nonthyroidal illness syndrome on hospital outcome in patients with acute heart failure

Wang Rui; Dong Tian-fu; Shen Jun; Li Shu-qin; Huang Tao; Wang Ying; Kang Xiu-wen

doi:10.3969/j.issn.1002-1949.2018.04.008

Abstract：Objective To evaluate the correlation between the level of free serum triiodothyronine(FT3) in hospitalized patients with acute heart failure (HF) and the outcome of patients in hospital.Methods A total of 189 HF patients who were treated in the intensive care unit of Department of Cardiology in our hospital were selected.On the first day and the seventh day after admission,the patients' serum FT3 indexes were detected.The patients were divided into the low FT3 group(n =91) and the normal FT3 group(n =98) according to whether the patients had the nonthyroidal illness syndrome (NTIS).The clinical data of the two groups and the outcome of the hospital were compared.The multivariate linear regression model was used to evaluatc the correlation between patients' hospitalization time and other variables.Logistic regression analysis was used to evaluate the independent factors of the patient's time of hospitalization.Results The admission FT3 levels was negatively correlated with the patient's length of stay (R =-0.590,P =0.013).Compared with the normal FT3 group,the hospitalization time[12(8,25)d vs.8(7,20)d,Z =5.268,P ＜0.001] and the percentage of patients with invasive mechanical ventilation [8.8％ (8/91) vs.2.0％ (2/98),x2 =28.841,P ＜ 0.001] in the low FT3 group were significantly increased.There was no statistically significant difference in mortality between the low FT3 group and the normal FT3 group [2.2％ (2/91) vs.0,x2 =1.154,P =0.283].The level of FT3 was independent of the patient's hospitalization time [OR =0.617,95％ CI 0.494 ～ 0.770,P ＜ 0.001].On the 7th day after admission,the T3 index of 25 patients with low FT3 returned to normal (T3 recovery group,n =25).Compared with 66 patients without T3 recovery (T3 non-recovery group,n =66),the hospitalized time,the proportion of patients with invasive mechanical ventilation,the proportion of patients admitted to hospital in T3 recovery group patients were significantly lower (P all ＜ 0.05).Conclusion Low T3 levels indicate a poor hospital outcome in acute HF patients.Doctors can stratify patients at risk according to the different levels of FT3 at admission to HF patients,and further give different treatment to HF patients.The return of low T3 levels can significantly improve the patient's hospital outcome.