CLINICAL ANALYSIS ON ALTERATION OF THYROID HORMONE IN ACUTE STROKE PATIENTS AND ITS EFFECT ON CLINICAL OUTCOME
Salil Kumar Pal, Tuhin Santra*, Neha Agrawal, Apu Adhikary, Mita Bar, Kunal Ranjan and Kingshuk Bhattacharjee
ABSTRACT
Background: Thyroid hormone has been found to be significantly altered in critically ill patients. Low T3 and low
T4 level has been found to be associated with poor outcome in critically ill patients while elevation of TSH level
has been shown to be associated with better outcome in stroke patients. Objective: To determine level of alteration
of thyroid hormones in acute stroke patients and its short term effect on clinical outcome. Methodology: Patients
without any history of thyroid hormone abnormality who presented with first episode of stroke within 72 hours
were studied. Results: Low or low normal T3 (≤0.80 ng/ml) has been found to be the commonest abnormality
(49.4% of patients). Patients with low T3 group and low TSH group (thyroid stimulating hormone) showed poor
neurological presentation and worse clinical outcome whereas patients with high TSH group showed significantly
low short term mortality (7 day mortality rate was 0%). Patients with high T3 and high T4 level in ischemic stroke
group also showed poor neurological status at presentation and worse clinical outcome. Conclusion: It is suggested
that thyroid hormones measurement after an acute stroke may be an important predictor of stroke outcome. If such
a relationship between thyroid function and prognosis of stroke are demonstrated in a randomized controlled trial,
thyroid function monitoring can be recommended in all acute stroke patients to optimize furthur treatment
measures.
Keywords: Alteration of thyroid hormone; acute stroke; clinical outcome.
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