Preoperative low tri-iodothyronine concentration is associated with worse health status and shorter five year survival of primary brain tumor patients

BACKGROUND: Low tri-iodothyronine syndrome is associated with worse prognosis of severely ill patients. We investigated the association of thyroid hormone levels with discharge outcomes and 5-year mortality in primary brain tumor patients. METHODS: From January, 2010 until September, 2011, 230 patie...

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Detalles Bibliográficos
Autores principales: Bunevicius, Adomas, Deltuva, Vytenis Pranas, Tamasauskas, Sarunas, Smith, Timothy, Laws, Edward R., Bunevicius, Robertas, Iervasi, Giorgio, Tamasauskas, Arimantas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Impact Journals LLC 2016
Materias:
Research Paper
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352429/
https://www.ncbi.nlm.nih.gov/pubmed/28055959
http://dx.doi.org/10.18632/oncotarget.14376
Descripción
Sumario:BACKGROUND: Low tri-iodothyronine syndrome is associated with worse prognosis of severely ill patients. We investigated the association of thyroid hormone levels with discharge outcomes and 5-year mortality in primary brain tumor patients. METHODS: From January, 2010 until September, 2011, 230 patients (70% women) before brain tumor surgery were evaluated for cognitive (Mini mental State Examination; MMSE) and functional (Barthel index; BI) status, and thyroid function profile. The Low triiodothyronine syndrome was defined as triiodothyronine concentration below the reference range. Unfavorable discharge outcomes were Glasgow outcome scale score of ≤3. Follow-up continued until November, 2015. RESULTS: Seventy-four percent of patients had Low triiodothyronine syndrome. Lower total tri-iodothyronine concentrations were associated with lower MMSE (p=.013) and BI (p=.023) scores independent of age, gender and histological diagnosis. Preoperative Low tri-iodothyronine syndrome increased risk for unfavorable discharge outcomes adjusting for age, gender and histological diagnosis (OR=2.944, 95%CI [1.314-6.597], p=.009). In all patients, lower tri-iodothyronine concentrations were associated with greater mortality risk (p≤.038) adjusting for age, gender, extent of resection, adjuvant treatment and histological diagnosis. The Low tri-iodothyronine syndrome was associated with greater 5-year mortality for glioma patients (HR=2.197; 95%CI [1.160-4.163], p=.016) and with shorter survival (249 [260] vs. 352 [399] days; p=.029) of high grade glioma patients independent of age, gender, extent of resection and adjuvant treatment. CONCLUSIONS: The Low tri-iodothyronine syndrome is common in brain tumor patients and is associated with poor functional and cognitive status, and with worse discharge outcomes. The Low tri-iodothyronine syndrome is associated with shorter survival of glioma patients.

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