Effects of Nonthyroidal Illness Syndrome on Functional Outcomes in Patients with Stroke

Abstract

Objectives: The purpose of the study was to investigate the effect of nontiroidal illness syndrome (NTIS) on functional outcomes in patients with stroke. Materials and Methods: The study included 204 (116 women, 88 men) patients with stroke due to cerebrovascular events. Acute and subacute stroke patients were included. Patients who had thyroid disease, severe liver disease and those diseases that lead to metabolic abnormalities were excluded. Demographic and clinical datas were recorded. Serum fT3, fT4 and TSH levels were investigated at admission. Functional Independence Measure (FIM) was used for functional assessment at admission and at discharge. Results: It was identified that in 60 of 204 patients (29.4%) had NTIS. Patients with NTIS (group 1) and without NTIS (group 2) had similar demographic characteristics (p>0.05). Admission (p=0.006) and discharge (p=0.005) FIM values of group 1 patients were statistically lower than group 2 patients. There was no significant difference between the groups in terms of FIM gain (FIM discharge-FIM admission) scores (p=0.425). In contrast, length of hospital stay of the patients in group 1 (45.20± 8.97 days) was found to be significantly longer (p=0.01) than group 2 (34.02±10.56 days). NTIS prevalence was 21.7% among acute stroke patients and 66.7% among subacute stroke patients. In multiple regression analysis, lower fT3 levels were independently associated with longer rehabilitation length of stay. Conclusion: Functional status of patients with NTIS was worse than patients with non-NTIS both at hospital admission and at discharge. Benefits derived from the rehabilitation program was similar in both groups, however NTIS prolong the duration of rehabilitation in patients with stroke.