Background: This study aimed to assess non-thyroidal illness syndrome (NTIS) as a prognostic determinant in sepsis, severe sepsis, and septic shock cases by evaluating TH levels. Method: A systematic search was performed through electronic databases including Pubmed, Embase, Scopus, and Medline. Result: A total of 843 patients from 9 studies were included in this analysis. In septic patients, the lowest effect size of thyroid function parameter was TSH (g= 2.05; 95% CI = 1.56-2.54), while T3, fT3, and fT4 had the lowest effect size in severe septic patients (g[95% CI] = 0.83[0.22-1.44]; 1.92[0.57-3.27]; 1.00[0.87-1.13]). Patients with septic shock had the highest effect size of TSH (g= 2.08; 95% CI = 1.54-2.61) and fT4 (g= 9.26; 95% CI = 0.98-17.53). Meanwhile, the lowest was T4 (g= 65.60; 95% CI = 64.63-66.57) and rT3 (g= 0.29; 95% CI = 0.24-0.34). Lower effect size of T3 (g= 0.83; 95% CI = 0.76-0.91), T4 (g= 59.48; 95% CI = 57.92-61.04), fT3 (g= 2.25; 95% CI = 1.83-2.66), and fT4 (g= 9.19; 95% CI = 1.56-16.81) were found in non-survivor groups. Conclusion: TH levels differ according to the severity of septic patients. NTIS is a prognostic factor in septic patients and is associated with the risk of mortality.
Key words: non-thyroidal illness syndrome, euthyroid sick syndrome, sepsis, septic shock, prognosis.
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