Stress Induced Changes in Insulin and Thyroid Level in Seriously Ill Patient in Intensive Care Unit and Their Influence in Final Outcome

BACKGROUND Stress is an important cause of hormonal imbalance. Alteration in hormones is observed in critically ill patients admitted to ICU. We observed the changes in thyroid profile and glycemic status of patients on admission and analyzed the correlation with their final outcome. MATERIAL AND METHODS In this cross sectional study, patients admitted to ICU were subjected for complete physical examination and a single fasting blood sample was obtained at admission for analyzing the biochemical parameters of thyroid and glycemic profile. The severity of illness was scaled using APACHE II scoring system. The patients were divided into two groups Group 1 survivors (discharged from the hospital) and Group 2 non-survivors (patient succumbed to their illness inside hospital). The final outcomes of the patients were compared to their hormonal balance. RESULTS The baseline demographic profile was comparable between survivors and non- survivors. The mean age of participants was 50.4 19.77 years and the mean duration of ICU stay was 3.33.1 days. A total of 22 patients survived, whereas remaining 18 succumbed to their illness. Non survivors had low free T3 when compared with survivors (0.87 0.65 vs.1.84 1.18, p = 0.002) and a high APACHE II score (206.85 vs.148.96, p= 0.028). CONCLUSION The study showed that low free T3 and high APACHE II score is an important marker of mortality in critically ill patient.