Background. Although extensively investigated, the prognostic role of thyroid hormone abnormalities in older participants remains uncertain. We investigated the relationship between thyroid hormones and mortality during hospitalization and in a prolonged follow-up in frail older patients. Methods. A nonconcurrent cohort study was conducted by enrolling 450 participants hospitalized for an acute disease, who were classified into four groups (euthyroidism, hypothyroidism, hyperthyroidism, and low triiodothyronine [T3] syndrome), according to clinical and laboratory data. Multidimensional geriatric assessment variables were considered in order to identify short- and long-term predictors of death. Results. Participants were very old (mean age: 84 years) and frail, as indicated by severely impaired functional status, extensive comorbidity, high prevalence of dementia, and hospital mortality (8%). Prevalence of any thyroid dysfunction was 40.7%; 32% of participants had low T3 syndrome, which was associated with an excess hospital mortality risk (odds ratio: 2.7, 95% confidence interval [CI]: 1.1–6.5; p = .025), adjusted for demographic, clinical, functional, and laboratory data. Conversely, long-term mortality was unrelated to low T3 syndrome. In euthyroid participants, increasing levels of free thyroxine (FT4) were associated with a slightly greater mortality (hazard ratio, CI: 2.12, 0.99–4.54; p = .053) in adjusted Cox regression models. Conclusions. This observational study on a cohort of very old, frail hospitalized patients gives support to the independent prognostic short-term, but not long-term, role of low T3 syndrome. Moreover, in older euthyroid participants, increasing levels of FT4 are a weak marker of poorer long-term survival. Thyroid hormones may help monitor changes in general health status and predict short- and long-term clinical outcomes in very old, frail patients.
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|Titolo:||Thyroid hormones as predicotrs of short- and long- term mortality in very old hospitalized patients|
|Citazione:||W., D.A., Nistico, F., T., B., F., R., F., C., C., M., et al. (2013). Thyroid hormones as predicotrs of short- and long- term mortality in very old hospitalized patients. JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 1-7.|
|Appare nelle tipologie:||1.1 Articolo in rivista|