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首页> 外文期刊>Southern African Journal of Critical Care >An audit of thyroid function testing in acutely ill patients at a South African academic hospital
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An audit of thyroid function testing in acutely ill patients at a South African academic hospital

机译：南非学术医院急性病患者甲状腺功能检测的审计

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BACKGROUND: Non-thyroidal illness syndrome (NTIS) can be defined as the presence of abnormal thyroid function in the absence of primary thyroid dysfunction and is associated with acute illness. Thyroid function testing is generally not advised in the critically ill patient. Thyroid-stimulating hormone (TSH) measurement is the preferred screening test for thyroid disease, but results may be misleading and variable in the setting of critical illnessOBJECTIVE: To describe the pattern of requests for TSH testing in patients admitted to the emergency department and intensive care units at Tygerberg Hospital, Cape Town, South AfricaMETHODS: A retrospective, descriptive (observational) study was conducted over a 6-month period to determine the number of requests for TSH testing received for patients admitted to the emergency department and intensive care unitsRESULTS: A total of 1 139 requests for TSH testing were received from the emergency department and intensive care units, of which 166 were excluded. Of the 973 requests evaluated, 14% yielded abnormal results. The majority (79.4%) of the abnormal TSH results were most likely attributed to NTIS. Follow-up TSH results after 6 - 8 weeks were available in only 18% of cases with abnormal TSH levels at initial presentationCONCLUSION: We found that TSH testing was often requested in critically ill patients, but that most results were either normal or indicative of NTIS. Follow-up testing of abnormal TSH results was rarely performed. We recommend continued education of junior clinicians regarding thyroid function testing in critically ill patients.
机译：背景：非甲状腺疾病综合征（NTI）可以定义为在没有初级甲状腺功能障碍的情况下存在异常甲状腺功能，并且与急性疾病有关。甲状腺功能测试通常不会在批判性患者中建议。甲状腺刺激激素（TSH）测量是甲状腺疾病的优选筛查试验，但在临界疾病的环境中，结果可能是误导性和可变的：描述患者患者的TSH测试请求模式，并进行了急诊部门和重症监护Tygerberg Hospital，Cape Town，南非米德米德斯的单位：在6个月的时间内进行了回顾性，描述性（观察性）研究，以确定为入院的患者收到的TSH测试的请求次数：a从急诊部门和重症监护单位收到139个TSH测试请求，其中排除了166个。在评估的973个请求中，14％产生了异常结果。大多数（79.4％）的异常TSH结果最有可能归因于NTIS。 6-8周后的后续TSH结果仅为初始呈现的异常TSH水平的18％的案例可供选择：我们发现经常在危重病人身上要求进行TSH测试，但大多数结果都是正常的或指示NTIS 。很少进行对异常TSH结果的后续测试。我们建议在临床病患者中继续教育初级临床医生。

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