INFLUENCE OF NUTRITION, THYROID-HORMONES, AND RECTAL TEMPERATURE ON IN-HOSPITAL MORTALITY OF ELDERLY PATIENTS WITH ACUTE ILLNESS

The present study was undertaken to investigate the interrelation of nutrition, core temperature, and thyroid function and their influence on survival of patients aged greater than or equal to 70 y admitted to the hospital with acute conditions. Sixty-seven patients entered the study. Nutritional state, thyroid function, rectal temperature, and the APACHE II score were recorded at admission. The patients were followed until death or hospital discharge. Patients with a serum albumin concentration <35 g/L showed a lower triiodothyronine (T-3) concentration, a higher reverse triiodothyronine (rT(3)) concentration, and a higher death rate. Prior weight loss (greater than or equal to 10%) did not influence thyroid status but increased the mortality rate. Eleven patients were hypothermic (<36.5 degrees C) and had a higher mortality, lower total T-3 concentration, and higher rT(3) concentration than the normothermic or hyperthermic subjects. Serum albumin, body weight, and total T-3 concentration were higher in survivors (n = 51) than in nonsurvivors (n = 16). Ongoing weight loss and hypoalbuminemia at admission are highly prevalent in elderly people with acute disease, and influence their clinical outcome. Mild hypothermia was a good predictor of death. Hypoalbuminemia and hypothermia were associated with low T-3 and high rT(3) values.