Περίληψη:
Objective It has been reported that hypothyroidism is associated with
better survival in elderly persons. We investigated possible
associations of thyroid status with clinical outcome in patients with
acute stroke.
Design Retrospective analysis.
Patients Consecutive patients (median age 70 years) admitted for acute
stroke.
Measurements Total T3, T4 and TSH levels. Stroke severity evaluation
using the Scandinavian Stroke Scale (SSS) and the Glasgow Coma Score
(GCS). Handicap and survival assessment over 12 months.
Results Of 744 patients where thyroid function tests were available
within the first 24 h of stroke, 13 had elevated TSH (>= 10 mu U/ml;
range 10-42 mu U/ml) (hypo-group), 51 had mildly elevated TSH (3.3-9.9
mu U/ml) and 680 had nonelevated TSH < 3.3 mu U/ml. In the hypo-group
transient ischaemic attacks (TIA’s) were more prevalent (46.2%)
compared to the groups of mildly elevated TSH (11.8%) and nonelevated
TSH (12.4%, P < 0.002). Hypo-group had more frequently an adequate
level of consciousness (GCS 14-15 = fully alert): 92.3% vs 74.5% and
63.7% (P = 0.033), a milder neurological deficit (SSS score 45-58)
76.9% vs 39.2% and 38.7% (P = 0.02) compared to the other two groups,
respectively, and a tendency for lower glucose levels on admission. One
year outcome tended to be better with respect to survival and handicap.
Conclusions Acute stroke patients with laboratory findings compatible
with pre-existing hypothyroidism on admission, appear to have better
clinical presentation and outcome; we speculate that a reduced response
to stress and previous TIA’s, possibly related to endogenous
‘preconditioning’, may contribute to this phenomenon.
Συγγραφείς:
Alevizaki, Maria
Synetou, Margaret
Xynos, Konstantinos and
Alevizaki, Calliope C.
Vemmos, Kostas N.
