Non-Thyroidal Illness Syndrome as a Predictor for Mortality in ICU Patients
Khalil, R., Mohamed Mahmoud, O., Ali Okab, E. (2025). Non-Thyroidal Illness Syndrome as a Predictor for Mortality in ICU Patients. EKB Journal Management System, 42(4), 371-381. doi: 10.21608/bmfj.2024.318644.2195
Reda Khalil; Omar Mohamed Mahmoud; Engy Ali Okab. "Non-Thyroidal Illness Syndrome as a Predictor for Mortality in ICU Patients". EKB Journal Management System, 42, 4, 2025, 371-381. doi: 10.21608/bmfj.2024.318644.2195
Khalil, R., Mohamed Mahmoud, O., Ali Okab, E. (2025). 'Non-Thyroidal Illness Syndrome as a Predictor for Mortality in ICU Patients', EKB Journal Management System, 42(4), pp. 371-381. doi: 10.21608/bmfj.2024.318644.2195
Khalil, R., Mohamed Mahmoud, O., Ali Okab, E. Non-Thyroidal Illness Syndrome as a Predictor for Mortality in ICU Patients. EKB Journal Management System, 2025; 42(4): 371-381. doi: 10.21608/bmfj.2024.318644.2195

Non-Thyroidal Illness Syndrome as a Predictor for Mortality in ICU Patients

Benha Medical Journal
Article 4, Volume 42, Issue 4, April 2025, Page 371-381  XML PDF (552.33 K)
Document Type: Original Article
DOI: 10.21608/bmfj.2024.318644.2195
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Authors
Reda Khalil1; Omar Mohamed Mahmoud email 2; Engy Ali Okab3
1Professor of Anesthesia and Intensive Care Unit, Faculty of Medicine, Benha Universityn Egypt
2Department of Critical Care Medicine, Faculty of Medicine, Benha University, Egypt
3Lecturer of Critical Care Medicine, Faculty of Medicine, Benha University, Egypt
Abstract
Background: Thyroid hormones (TH) are essential for cellular growth, differentiation, and energetic regulation. Critical illness is frequently associated with alterations in TH metabolism not caused by abnormalities of the hypothalamic-pituitary-thyroid function. These changes, collectively known as non-thyroidal illness syndrome (NTIS). This study aimed to investigate the role of NTIS in prediction of mortality in ICU Patients. Methods: This prospective cohort study was carried out on 50 ICU patients in the Department of Intensive Care Unit in Benha University Hospitals. After diagnosis of NTIS patients were categorized into two groups: Non-NTIS group and NTIS group. Results: Multivariate regression analysis identified ALT, SAPS III, APACHE II, sepsis, ARDS, mechanical ventilation, liver cell failure, and ICU length of stay as significant independent predictors of NTIS. For in-hospital mortality, WBC count, albumin, ALT, NTIS, APACHE II score, ARDS, need for mechanical ventilation, liver cell failure, and ICU length of stay were identified as significant predictors. Our ROC curve analysis demonstrated that both fT3 and fT4 levels have good diagnostic performance in predicting in-hospital mortality. A cut-off value of fT3 < 2 pmol/L showed 90.8% sensitivity and 81.3% specificity, while fT4 < 10 pmol/L demonstrated 90.9% sensitivity and 85.2% specificity. Conclusions: our study demonstrates that NTIS is common among ICU patients and is associated with increased disease severity, higher complication rates, and increased mortality. The strong predictive value of fT3 and fT4 levels for in-hospital mortality suggests that thyroid function tests could be valuable additions to prognostic models in the ICU setting.
Keywords
Non-Thyroidal Illness Syndrome; NTIS; Mortality; ICU
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