High prevalence of non-thyroidal illness syndrome in patients at long-term care facilities
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ORIGINAL ARTICLE
High prevalence of non-thyroidal illness syndrome in patients at long-term care facilities Joaquin Lado-Abeal 1 Carmen Diaz2 Gilbert Berdine3 Kenneth Iwuji 4 David Araujo-Vilar 2,5 Natalia Lampon-Fernandez6 Min Wang 7 Santiago Lojo 6 Alfonso Rodriguez-Perez8 Ana Marcella Rivas ●
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Received: 7 March 2020 / Accepted: 16 April 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Patients in acute care hospitals are often transferred to long-term care (LTC) when there is an expectation for a lengthy recovery. Prolonged non-thyroidal illness syndrome (NTIS) creates a state of hypothyroidism. We aimed to investigate the prevalence of NTIS in patients at LTC facilities. Methods A cross-sectional study at University Hospitals and Rehabilitation and Skilled Nursing facility was performed. Four groups: control (n:33), intensive care unit (ICU) (n:34), long-term care hospital (LTCH) (n:50), and long-term care on chronic ventilatory support (LTCVS) (n:30). Serum levels of TSH, free T4 (FT4), free T3 (FT3), and interleukin 6 (IL6) measured at admission day in controls, within 48 h of admission in the intensive care group, between days 31 and 120 in the LTC hospital group and days 31 and 6 years in the LTC on chronic ventilatory support group. Results Serum FT3 levels were lower in groups intensive care unit ICU, LTCH, and LTCVS than control. Low serum FT3 levels were observed in 80% ICU, 54% LTCH, 37% LTCVS, and 6% control patients. Low serum FT4 levels were observed in 32% ICU, 16% LTCH, and 20% LTCVS patients. Both low serum FT4 and FT3 levels were observed in 32% ICU, 16% LTCH, and 13% LTCVS patients. Serum IL6 and FT3 levels showed a negative correlation. Conclusions NTIS is highly prevalent in patients in LTC, creating a state of persistent hypothyroidism. The effects of thyroid hormone replacement in patients at LTC with non-thyroidal illness deserve further investigation. Keywords Non-thyroidal illness syndrome Long-term care Hypothyroidism Thyroid hormone ●
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* Joaquin Lado-Abeal [email protected] 1
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Psychiatry, Radiology, Public Health, Nursing and Medicine (Medicine Area), Centre for Research in Molecular Medicine and Chronic Diseases (CIMUS)-IDIS, University of Santiago de Compostela School of Medicine, Santiago de Compostela, Spain
Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Truman Medical Centers and University of Missouri Kansas City, Kansas City, MO, USA
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Division of Endocrinology and Nutrition, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Santiago de Compostela, Spain
Division of Clinical Analysis, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Santiago de Compostela, Spain
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Department of Management Science and Statistics, The University of Texas at San Antonio, San Antonio, TX, USA
Department of Internal Medicine, Division of Pulmonary Disease and Critical Care,
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