Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study
-
Jia Song
,
Jiaying Dou
Abstract
Background
Thyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.
Methods
We performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.
Results
Ninety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.
Conclusions
Nonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.
Authors’ contributions: Conceived and designed the study: JS, YC, CW, and YZ. Collected blood samples and analyzed data: JS, JD, HM, and XX. Contributed analysis tools and discussion: JS, YC, CW, and YZ. Wrote the paper: JS, CW, and YZ. All the authors have read, revised, and approved the final paper submitted for publication.
Research funding: This study was supported by the Science and Technology Commission of Shanghai Municipality (16411970300, 18411951000), the multicenter Clinical Research Program of Shanghai Jiao Tong University School of Medicine (DLY201618). Jia Song is supported by the Talents Program of Shanghai Jiao Tong University School of Medicine (JQ201804). Chunxia Wang is supported by the Shanghai Municipal Education Commission–Gaofeng Clinical Medicine Grant support (20171928) and the Talents Program of Shanghai Jiao Tong University School of Medicine (17XJ11018).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Disclosure statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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Artikel in diesem Heft
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Artikel in diesem Heft
- Frontmatter
- Reviews
- Occurrence and clinical management of nonalcoholic fatty liver disease in obesity patients: a literature review
- Does obesity have an effect on the ECG in children?
- Original Articles
- Factors associated with oxidative stress status in pediatric patients with type 1 diabetes mellitus
- The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes
- Psychiatric view for disorders of sex development: a 12-year experience of a multidisciplinary team in a university hospital
- Effect of high-dose vitamin D supplementation on antibody titers to heat shock protein 27 in adolescent girls
- Effects of whole-body vibration training on bone density and turnover markers in adolescent swimmers
- Estimations of total serum testosterone levels in Nigerian term neonates at birth using anogenital distance measurements
- Inborn errors of metabolism detectable by tandem mass spectrometry in Beijing
- Identification of two novel variants in GNPTAB underlying mucolipidosis II in a Pakistani family
- Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study
- Case Reports
- First Scandinavian case of successful pregnancy during nitisinone treatment for type 1 tyrosinemia
- A novel etiologic factor of highly elevated cholestanol levels: progressive familial intrahepatic cholestasis
- Congenital hyperinsulinism due to compound heterozygous mutations in ABCC8 responsive to diazoxide therapy
- Hyperinsulinism hyperammonaemia (HI/HA) syndrome due to GLUD1 mutation: phenotypic variations ranging from late presentation to spontaneous resolution
- Corrigendum
- Corrigendum to: The effects of a 12-week jump rope exercise program on body composition, insulin sensitivity, and academic self-efficacy in obese adolescent girls
