1. Thyroid hormone profile is related to prognosis in acute decompensation of cirrhosis.
- Author
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Nardin G, Colombo BDS, Ronsoni MF, Silva PESE, Fayad L, Wildner LM, Bazzo ML, Dantas-Correa EB, Narciso-Schiavon JL, and Schiavon LL
- Subjects
- Humans, Female, Male, Prognosis, Middle Aged, Prospective Studies, Aged, Acute-On-Chronic Liver Failure blood, Acute-On-Chronic Liver Failure mortality, Thyrotropin blood, Triiodothyronine blood, Thyroxine blood, Severity of Illness Index, Adult, ROC Curve, Thyroid Function Tests, Liver Cirrhosis blood, Liver Cirrhosis mortality, Liver Cirrhosis complications, Thyroid Hormones blood
- Abstract
Objective: To investigate the prognostic significance of thyroid hormone profile in patients hospitalized for decompensated cirrhosis., Subjects and Methods: Prospective cohort study that included 119 subjects. All subjects were evaluated at admission and followed for 90 days. TSH, fT3, fT4 were measured within 24 hours of hospitalization., Results: Higher fT4 and lower fT3 levels were observed among Child-Pugh C patients as compared to Child-Pugh A and B, and in those with acute-on-chronic liver failure (ACLF). Lower fT3/fT4 ratio was observed in those with ascites, infections, ACLF, and in Child-Pugh C. Ninety-day mortality was 26.9% and it was independently associated with higher Model for End-stage Liver Disease (MELD) and TSH, and lower fT3/fT4 ratio in multivariate analysis. A new prognostic model including MELD, TSH and fT3/fT4 ratio was devised. The areas under the receiver operating characteristic curves for MELD, fT3/fT4 ratio, TSH (μIU/mL), and the new model for predicting 90-day mortality were 0.847 ± 0.041, 0.841 ± 0.039, 0.658 ± 0.062, and 0.899 ± 0.031, respectively. The 90-day survival was 31.6% in patients with values of the predictive model ≥ -0.77 and 93.5% for values < -0.77 (P < 0.001)., Conclusions: Thyroid hormone profile was strongly associated with worse outcomes in patients with cirrhosis and might represent promising prognostic tools that can be incorporated in clinical practice., Competing Interests: Disclosure: no potential conflict of interest relevant to this article was reported.
- Published
- 2024
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