The Association Between Thyroid Hormone Levels and Mortality Outcomes Among Sepsis and Septic Shock Patients

Background: Sepsis is a life-threatening condition triggered by an overwhelming immune response to infection. It significantly contributes to global morbidity and mortality. Thyroid hormone imbalances are prevalent in critically ill patients and can exacerbate metabolic dysfunction and worsen clinical outcomes. Further investigation into these connections is crucial for improved patient care. Objectives: to study the relationship between thyroid hormone levels at baseline and outcomes of Sepsis and Septic Shock in critically ill patients. Patients and methods: This observational, cross-sectional study was conducted in the general ICU at Maadi Military Medical Hospital, involving 62 critically ill patients with sepsis or septic shock. Patients aged 18 and older with culture-confirmed infections were included. Individuals with preexisting thyroid or cardiovascular conditions were excluded from the study. Results: mean age of 52.3 years, a gender distribution that is about equal, and common comorbidities including diabetes (25.8 percentage) and hypertension (43.5 percentage). Thyroid hormone levels were greater in survival, and the mortality rate was 50 percentage (FT3, FT4). With an AUC of 0.886, FT3 showed a significant mortality prediction. Thyroid hormone levels, organ function, and infection all affect patient outcomes and are important indicators of prognosis in critical care settings. Conclusion: The study highlights the strong association between thyroid hormone levels, particularly FT3, and patient outcomes in critically ill patients with sepsis and septic shock. Lower levels of FT3 and FT4 were linked to increased disease severity, prolonged ICU stays, and higher mortality rates. Notably, FT3 emerged as a particularly strong predictor of mortality. These findings suggest that monitoring thyroid hormone levels may be valuable in identifying high-risk patients and guiding therapeutic interventions to improve clinical outcomes in this patient population.