Study Of Thyroid Function Tests In Hospitalised Aged People Over 90 Years Old

Objective1.To study the thyroid dysfunction of the hospitalized patients who are 90 years old and over. 2. To study the merger diseases, metabolism and nutritional status of old patients under different thyroid function and the effect of thyroid dysfunction to motality.3. To improve the understanding of whether the state of thyroid function in old patients will impact on the disease outcome.MethodsWe studied a group of 204 patients aged 90 years old and over, in our geriatric department in Ruijin Hospital between 2010.1.1 and 2014.12.31,and collected all the medical records of them(including basic information,thyroid function test result, routine biochemical tests,past history and etc). We also recorded the death cases and the cause of death who died before December 31, 2014.The patients were grouped by two methods,thyroid function and survival status,and then we analyzed and compared the recorded items.ResultsOf all the 204 patients, 88 patients showed alterations in thyroid function. Euthyroid sick syndrome(ESS) was the most frequently and accounted for 33.8%(n=69,33.8%),while 16 patients showed hypothyroidism and subclinical hypothyroidism(n=16,7.8%),subclinical hyperthyroidism,3(1.5%), and no hyperthyroidism. Nutrition indicators of ESS were lower than the euthyroidism group, while the triglycerides of thehypothyroidism and subclinical hypothyroidism group was higher than the euthyroidism group. The mortality of ESS is much higher than the euthyroidism group(P=0.003). The result of regression analysis showed that when FT4 rises, the risk of death increases.Serum levels of FT3 and albumin were negatively related to death.ConclusionIn the elderly people over 90 years old, the prevalence of alterations in thyroid function tests was high, and ESS was the most common category, of which low plasma T3 makes the maximum proportion. The occurrance of low plasma T3 meant poor prognosis. The differences between ESS group and the normal group showed on nutrition related indicators,while the one between hypothyroidism and subclinical hypothyroidism group and the euthyroidism group showed on metabolism indexes.Abnormal thyroid function is closely related to the risk of death.The reducing of plasma T3 and FT3 means the increased risk of death,while plasma was opposite to them. Low serum FT3 and albumin are the independent predictors of death of the old.