Volume 28, Issue 6 (Iran South Med J 2026)
Iran South Med J 2026, 28(6): 926-939 |
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VatanKhah Tarbehbar M, Kazemijahromi M, Zarei T Z, Mohammadi M, Mabani M, Zare S et al . Changes in Thyroid Function Tests in Head Trauma Patients Admitted to the Intensive Care Unit: A Cross-Sectional Study. Iran South Med J 2026; 28 (6) :926-939
URL: http://ismj.bpums.ac.ir/article-1-2470-en.html
URL: http://ismj.bpums.ac.ir/article-1-2470-en.html
Majid VatanKhah Tarbehbar1 
, Mitra Kazemijahromi1 , Tayebeh Zarei Zarei1 , Milad Mohammadi1 , Maryam Mabani1 , Shahram Zare1 , Mehrdad Malek Shoar *2
, Mitra Kazemijahromi1 , Tayebeh Zarei Zarei1 , Milad Mohammadi1 , Maryam Mabani1 , Shahram Zare1 , Mehrdad Malek Shoar *2
1- Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2- Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran ,mehrdad.malek@hums.ac.ir
2- Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran ,
Abstract: (178 Views)
Background: Traumatic brain injury is among the leading causes of mortality and disability in patients admitted to intensive care units (ICUs). In these patients neuroendocrine changes are complex and have a major impact on the hypothalamic-pituitary-thyroid axis. The present study was performed to assess the alterations in thyroid function tests in trauma patients admitted to the ICU of Shahid Mohammadi Hospital, Bandar Abbas.
Materials and Methods: This descriptive-analytical cross-sectional study was performed from March to September 2025 with 100 patients with head trauma admitted to the ICU. Demographic data, Glasgow Coma Scale scores, mechanical ventilation status, length of ICU stay, and clinical outcomes were recorded. Blood samples were collected within the first 24-48 hours of admission, and TSH, T3, and T4 were measured by Chemiluminescence Immunoassay (CLIA). Data were analyzed using the independent samples t-test, Mann–Whitney U test, chi-square test, and logistic regression in SPSS version 26.
Results: The median serum T3 level was 0.37 ng/mL (IQR: 0.30-0.79) in all patients, which was below the normal reference range. Non-survivors had significantly lower T3 and T4 levels (0.22 vs. 0.40 ng/mL, p = 0.001, and 3.90 vs. 5.10 µg/dL, p = 0.002, respectively) but no significant difference was observed in TSH levels (p = 0.210) compared with survivors. Reduced T3 was significantly associated with lower GCS score, longer ICU stay, and more dependence on
mechanical ventilation (P < 0.05). ROC curve analysis revealed that T4 was the strongest predictor of mortality (AUC, 0.738). Logistic regression analysis revealed T4 as the only independent predictor of in-hospital mortality (OR = 0.59; p = 0.009).
Conclusion: Reduction of thyroid hormones, especially T3 and T4, is significantly correlated with severity of injury, prolonged ICU stay, and poorer clinical outcomes in patients with head trauma. Therefore, early assessment of the thyroid hormone profile may prove to be a useful tool to assess disease severity and to guide clinical decision making. Additional research using serial hormonal sampling in longitudinal studies is needed.
Materials and Methods: This descriptive-analytical cross-sectional study was performed from March to September 2025 with 100 patients with head trauma admitted to the ICU. Demographic data, Glasgow Coma Scale scores, mechanical ventilation status, length of ICU stay, and clinical outcomes were recorded. Blood samples were collected within the first 24-48 hours of admission, and TSH, T3, and T4 were measured by Chemiluminescence Immunoassay (CLIA). Data were analyzed using the independent samples t-test, Mann–Whitney U test, chi-square test, and logistic regression in SPSS version 26.
Results: The median serum T3 level was 0.37 ng/mL (IQR: 0.30-0.79) in all patients, which was below the normal reference range. Non-survivors had significantly lower T3 and T4 levels (0.22 vs. 0.40 ng/mL, p = 0.001, and 3.90 vs. 5.10 µg/dL, p = 0.002, respectively) but no significant difference was observed in TSH levels (p = 0.210) compared with survivors. Reduced T3 was significantly associated with lower GCS score, longer ICU stay, and more dependence on
mechanical ventilation (P < 0.05). ROC curve analysis revealed that T4 was the strongest predictor of mortality (AUC, 0.738). Logistic regression analysis revealed T4 as the only independent predictor of in-hospital mortality (OR = 0.59; p = 0.009).
Conclusion: Reduction of thyroid hormones, especially T3 and T4, is significantly correlated with severity of injury, prolonged ICU stay, and poorer clinical outcomes in patients with head trauma. Therefore, early assessment of the thyroid hormone profile may prove to be a useful tool to assess disease severity and to guide clinical decision making. Additional research using serial hormonal sampling in longitudinal studies is needed.
Keywords: Brain Injuries, Traumatic, Hypothalamo-Hypophyseal System, Intensive Care Units, Pituitary-Thyroid System
Type of Study: Original |
Subject:
Anesthesiology
Received: 2025/12/18 | Accepted: 2026/05/19 | Published: 2026/06/10
Received: 2025/12/18 | Accepted: 2026/05/19 | Published: 2026/06/10
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