Correlation Of Thyroid Hormone Profile With Apache Ii Score As A Prognostic Marker In Patients With Sepsis In Intensive Care Unit - A One Year Cross -Sectional Study At Kles Dr Prabhkar Kore Hospital, Belagavi

Abstract

Background and Objectives The metabolic responses to sepsis involve every organ and tissue of the body. This study was designed to find correlation of sepsis and thyroid profile and to associate thyroid profile with APACHE II score. Methodology The present one year hospital based cross-sectional study was done in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi. A total of 100 patients with sepsis from January 2015 to December 2015 were studied. All the patients were investigated for thyroid profile. Results Out of 100 patients, 57% of the patients were males and 43% were females and male to female ratio was 1.32:1. 18 to 30 years was the most common age group comprised of 23% of the patients. The mean age was 48.55±18.09 years. Type 2 diabetes mellitus was the most common comorbid condition (29%). Most of the patients (18%) had APACHE II scores between 15 to 19. The mean APACHE II scores were 21.26±10.07. Thyroid profile assessment revealed low fT3 levels in 94% of the patients, low fT4 levels in 11% and low TSH levels in 18% of the patients. Most of the patients (68%) of the patients improved and discharged While mortality was noted in 32% of the patients. Pneumonia was the primary diagnosis noted in 31% of the patients followed by pyelonephritis (20%). Statistically significant association was found between APACHE II scores and outcome (p<0.001). There was moderate negative correlation between APACHE II scores and fT3 (ρ=-0.345; p<0.001) and weak negative correlation between APACHE II scores and fT4 (ρ=-0.019; p<0.848), and weak APACHE II scores with TSH (ρ=-0.061; p<0.545). Conclusion and Interpretation In ICU patients with sepsis, Thyroid profile in combination with the APACHE II score predicts outcome more accurately than the APACHE II scores alone. There is inverse relationship between APACHE II scores and fT3.