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Original Research

Open Access

Non-thyroid disease syndrome: a strong prognostic predictor of death in patients with pneumonia

  • Ejder Saylav Bora1
  • Adem Çakır2
  • Serkan Hacar1
  • Cüneyt Arıkan1
  • Güner Yurtsever1
  • Hüseyin Acar1

1Department of Emergency Medicine, Izmir Atatürk Training and Research Hospital, 35150 Izmir, Turkey

2Department of Emergency Medicine, Republic of Turkey Ministry of Health Basaksehir Pine and Sakura City Hospital, 34480 Istanbul, Turkey

DOI: 10.22514/sv.2021.069

Submitted: 19 February 2021 Accepted: 17 March 2021

Online publish date: 20 April 2021

*Corresponding Author(s): Ejder Saylav Bora E-mail:


Introduction: Non-thyroid disease syndrome (NTDS) is a common syndrome in critical diseases and is characterized by below-normal levels of free T3 (fT3) and free T4 (fT4) in the absence of primary thyroid gland pathology. Pneumonias are a group of respiratory system infections that are associated with a high incidence of mortality. Rapid biomarkers are needed to determine the diagnosis and prognosis in patients with pneumonia to optimize treatment potential. This study investigated the effect of changes in thyroid hormone and procalcitonin (PCT) levels on prognosis and mortality in patients with pneumonia.

Method: This study was conducted as a retrospective observational study in a tertiary hospital. Between 2019 and 2020, 1118 patients with pneumonia were included in the study. For all participants, PSI scores were calculated and disease severity was determined according to these scores. Patient demographic and disease data were recorded.

Discussion and Conclusion: Low fT3 hormone levels in patients diagnosed with pneumonia upon arrival at the emergency department had an important effect on prognosis. Our results indicated that fT3 levels had a reliable predictive effect on prognosis, disease severity, and mortality. In addition, we found that fT3 was superior to PCT in predicting mortality.


Emergency Service; Pneumonia; Euthyroid Sick Syndromes; Diagnosis

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Ejder Saylav Bora,Adem Çakır,Serkan Hacar,Cüneyt Arıkan,Güner Yurtsever,Hüseyin Acar. Non-thyroid disease syndrome: a strong prognostic predictor of death in patients with pneumonia. Signa Vitae. 2021.doi:10.22514/sv.2021.069.


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