Low TT4 as a predictor of poor outcomes in severe encephalitis: a multivariate analysis of 94 patients

Expert Rev Neurother. 2018 May;18(5):443-451. doi: 10.1080/14737175.2018.1452613. Epub 2018 Mar 20.

Abstract

Background: To investigate the prognostic value of acute thyroid function in patients with severe encephalitis.

Methods: We retrospectively analyzed information from patients with severe encephalitis from June 2012 to June 2017. Using multivariate logistic regression analysis, we examined predictors of poor outcomes in these patients after 6 months.

Results: A total of 94 patients with severe encephalitis were included in the study. Univariate analysis showed that patients with good or poor outcomes had significantly different total thyroxine (TT4) (P = 0.012) and free triiodothyronine (FT3) (P = 0.049) levels, mechanical ventilation requirements (P < 0.001), pulmonary infection complications (P = 0.001), lengths of neurological intensive care unit (P = 0.003) and total hospital (P = 0.012) stay, and Acute Physiology and Chronic Health Evaluation (APACHE II) (P = 0.005) and Glasgow Coma Scale (GCS) (P = 0) scores. The results of multivariate analysis suggested the following factors to be associated with a poor outcome: a low TT4 level (OR 0.303, 95% CI 0.100-0.923) and a low GCS score (OR 0.683, 95% CI 0.506-0.923).

Conclusions: Low TT4 has a predictive value for the adverse outcomes of severe encephalitis; further study is needed for verification.

Keywords: Encephalitis; neurological intensive care unit; outcome; predictor; total thyroxine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • APACHE
  • Critical Care
  • Encephalitis / blood*
  • Encephalitis / complications
  • Encephalitis / diagnosis
  • Encephalitis / therapy*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Length of Stay
  • Lung Diseases / etiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prognosis
  • Respiration, Artificial
  • Respiratory Tract Infections / etiology
  • Retrospective Studies
  • Thyroxine / blood*
  • Triiodothyronine / blood

Substances

  • Triiodothyronine
  • Thyroxine