Vol. 6, Issue 1, Part A (2020)

Background: In a host of critical illness there is a gross alteration of different endocrine parameters due to changes required to maintain internal homeostasis. Sick euthyroid syndrome characterized by low serum levels of free and total triiodothyronine (T3) and high levels of reverse T3 (rT3) accompanied by normal or low levels of thyroxine (T4) and thyroid-stimulating hormone (TSH) seen in patients with or without previous thyroid dysfunction is a common finding in the ICU setup. Hyperglycemia is also a common cause for increased mortality and morbidity. Prolactin is also one of the relatively new markers for sepsis. In this study these endocrine markers were studied in critically ill patients and their correlation with mortality was carried out.

Aims & Objectives: To correlate mortality with serum levels of Prolactin, HbA1c, and thyroid profile

Materials & Methods: In this single centre, prospective, observational study, 100 consecutive patients admitted to ICU irrespective of diagnosis were included. Patients with previous thyroid disorders were excluded. All participants underwent complete physical examination and laboratory parameters like free triiodothyronine (T3), freel thyroxine (T4), thyroid stimulating hormone (TSH), HbA1c, and prolactin were measured. The patients were divided into two groups: Group 1 – survivors (discharged from the hospital) and Group 2 – non survivors (patients succumbed to their illness inside the hospital). The data were analyzed by appropriate statistical methods and a P-value of <0.05 was considered significant.

Results: In all 100 patients were analysed among them 38 people survived and 62 succumbed to their illness. The mean free T3 among survivors was 1.61 and among non survivors was 1.13 with a p value <0.001 but there was no significant association between free T4 and TSH among the two groups. The mean HBA1C value among survivors was 6.21 and non survivors was 8.23 and P value was <0.001. The mean prolactin among survivors was 6.32 and among non survivors was 8.33 and P value was 0.03.

Conclusion: Serum free T3, HBA1C and prolactin levels was associated with poor prognosis in critically ill patients and should be measured in all patients admitted to ICU irrespective of diabetes and thyroid status.