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Cited by 10Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryHormonal and reproductive studies

Pre-admission TSH levels predict long-term mortality in adults treated for hypothyroidism

Akirov, Amit, Shochat, Tzipora, Shechvitz, Amir, Shimon, Ilan, Diker-Cohen, Talia, Robenshtok, Eyal·2017·Endocrine
DOI 10.1007/s12020-017-1453-8
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Abstract

Context Limited data is available regarding the association between pre-admission thyroid function and prognosis of hospitalized patients treated for hypothyroidism.Objective Evaluate an association between thyroid stimulating hormone (TSH) levels and mortality in hospitalized levothyroxine-treated patients.Design and setting Observational data of patients admitted to medical wards between 2011 and 2013. TSH levels obtained up to 180 days prior to admission were stratified as follows: low (≤0.5 mIU/L), normal (0.5-5 mIU/L), high (>5 mIU/L).Patients Patients aged 60-80 years with available thyroid function tests were matched with controls without hypothyroidism.Main outcome All-cause mortality up to 66-months following discharge.Results One thousand and fifty seven patients (73% females, mean (SD) age 71 ± 6 years) were matched with controls without hypothyroidism. Mean hospital stay and in-hospital mortality were not different between groups. Mortality risk at the end-of-follow-up was 41% (438/1057) and 37% (392/1057) for patients with and without hypothyroidism (p < 0.05). TSH levels were classified as follows: low, 84 patients (8%); normal, 667 patients (63%); high, 306 patients (29%). Length of hospitalization and in-hospital mortality were not different between TSH categories. Mortality risk at the end-of-follow-up was 30, 39, and 50% with low, normal and elevated TSH, respectively. Adjusted hazard ratio (95% CI) of mortality at the end-of-follow-up was of 2.2 (1.2-3.8) for high vs. low TSH levels, and 1.4 (1.1-1.9) for high vs. normal TSH levels.Conclusion In treated hypothyroid adult patients, increased TSH up to 6 months prior to admission is associated with increased mortality. Treatment should aim at achieving euthyroidism to improve survival.

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Crossref · 10.1007/s12020-017-1453-8

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  • Excessive levothyroxine treatment in patients of high age is associated with increased mortality.

    “Excessive LT4 treatment in patients of high age is associated with an increased mortality.”

    From Risks of suboptimal and excessive thyroid hormone replacement across ages (2023) · cites this paper as [41]

  • Several studies showed insufficiently treated overt and/or subclinical hypothyroidism as well as excessively replaced hypothyroid patients are associated with increased early mortality risk in older patients.

    “However, several studies showed insufficiently treated overt and/or subclinical hypothyroidism as well as excessively replaced hypothyroid patients associated with increased early mortality risk in older patients [41–44].”

    From Risks of suboptimal and excessive thyroid hormone replacement across ages (2023) · cites this paper as [41]

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Authors
Akirov, A., Shochat, T., Shechvitz, A., Shimon, I., Diker-Cohen, T., & Robenshtok, E.
Affiliations
  • Tel Aviv University (IL)
  • Rabin Medical Center (IL)
Corresponding author
Akirov, Amit
ORCID
Venue
Endocrine
Publisher
Springer Science and Business Media LLC
Published
2017-10-20
Volume
58
Issue
3
Pages
481-487
ISSN
  • 0969-711X (ISSN-L)
  • 1355-008X
  • 1559-0100
DOI
10.1007/s12020-017-1453-8
OpenAlex
W2766110187
Cited by
10
References
32
Citations by year
2025: 2 · 2023: 3 · 2022: 3 · 2019: 2
FWCI
0.43
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (unspecified)
Locations
  • Endocrine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
hypothyroidism, thyroid-stimulating hormone, TSH levels, mortality, levothyroxine, euthyroidism, hospitalized patients, long-term prognosis, older adults
MeSH terms
Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Hypothyroidism, Length of Stay, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Thyroid Function Tests, Thyrotropin, Thyroxine, Survival Analysis, Hospital Mortality, Risk Assessment, Kaplan-Meier Estimate

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