How reliable are thyroid hormone levels for predicting mortality before amputation?

INTRODUCTION: The aim of this study was to investigate the correlation between thyroid hormone (TH) levels before amputation and mortality.
METHODS: The 30-day and 1-year mortality rates of 194 patients (84 females and 110 males) who underwent lower extremity amputations in our clinic were retrospectively analyzed. To evaluate the relationship between TH levels and mortality, archival records were used to obtain necessary information such as age, gender, and TH levels. Patients were divided into six groups according to TH levels: control, overt hyperthyroidism, subclinical hyperthyroidism, euthyroid sick syndrome (ESS), subclinical hypothyroidism, and overt hypothyroidism.
RESULTS: The 30-day and 1-year mortality rates were 22.7% (44/194) and 52.6% (102/194), respectively. The log-rank test of the Kaplan–Meier curves revealed statistically significant differences in 30-day and 1-year survival rates between patients with different thyroid status. Univariate analysis showed that thyroid status was significantly associated with both 30-day mortality and 1-year mortality rates. In terms of 1-year mortality, ESS, overt hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism, and subclinical hyperthyroidism were associated with an increased risk of death compared to patients with normal thyroid function in the control group.
DISCUSSION AND CONCLUSION: The current study found that impaired TH levels were associated with 30-day and 1-year mortality after amputation in a geriatric population. Increasing age and overt hyperthyroidism were associated with a higher rate of postoperative complications.