Ren H, et al. - The association between preoperative Non-thyroidal illness syndrome (NTIS) and postoperative outcomes was explored in enterocutaneous fistula (ECF) patients. Researchers identified a greater risk for poor outcomes among ECF patients with NTIS before definitive surgery.

Methods

• Researchers studied a total of 264 ECF patients who underwent definitive surgery from April 2014 to November 2016.
• For each patient, thyroid hormones were tested before surgery; according to the presence of NTIS, the patients were divided into two groups (NTIS group and euthyroid group).
• Documentation and analysis of demographics, surgery-related data, and complications during the first 30 days after surgery were performed.

Results

• The prevalence of NTIS was 31.4% (83/264) among ECF patients accepted for definitive surgery.
• A single low free triiodothyronine (FT3) [28.0% (74/264)] was the most common presentation of NTIS, followed by low FT3 combined with low thyrotropin (TSH) 1.9% (5/264), and low free thyroxine (FT4) combined with low TSH 1.5% (4/264).
• More patients with NTIS had multiple ECF, received more than three months of enteral nutrition pre-operatively, and developed surgical site infections (SSI) compared to the euthyroid group.
• Researchers noticed a correlation of FT3 levels with risk of SSI.
• The diagnostic effectiveness of FT3 was revealed by receiver operating characteristic curve (ROC) analysis; the optimal cut-off value was 3.5pmol/L.
• In this study, area under the curve, sensitivity and specificity were 0.75, 72.6% and 68.7%, respectively.