Evidence map›Paper›PMID 42804119›Full record

SynthesisEndocrine2026

Non-thyroidal illness syndrome and isolated low triiodothyronine as prognostic markers in acute illness: a systematic review and meta-analysis.

Elisa Gatta, Virginia Maltese, Enrico Papini, Rinaldo Guglielmi, Roberto Negro, Massimo Salvetti, Carlo Cappelli

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elisa GattaDepartment of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili, Brescia, Italy.
Virginia MalteseDepartment of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili, Brescia, Italy.
Enrico PapiniDepartment of Endocrinology and Metabolism, Regina Apostolorum Hospital- Lifenet Health Group, Rome, Italy.
Rinaldo GuglielmiDepartment of Endocrinology and Metabolism, Regina Apostolorum Hospital- Lifenet Health Group, Rome, Italy.
Roberto NegroDepartment of Experimental Medicine, University of Salento, Lecce, Italy.
Massimo SalvettiCentro per la Diagnosi e Cura delle Neoplasie Endocrine e delle Malattie della Tiroide, University of Brescia, Brescia, Italy.
Carlo CappelliDepartment of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, ASST Spedali Civili, Brescia, Italy. carlo.cappelli@unibs.it.ORCID https://orcid.org/0000-0003-4317-1232

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the association between thyroid hormone alterations and mortality in critically ill and cardiovascular patients, and to compare the prognostic performance of non-thyroidal illness syndrome and isolated low triiodothyronine.

methodsPubMed/MEDLINE, Scopus, and Web of Science were systematically searched for studies published between 2014 and 2026 evaluating thyroid dysfunction and mortality in acute or critical illness. Studies assessing non-thyroidal illness syndrome or isolated low triiodothyronine were included. Random-effects meta-analyses were performed using odds ratios (ORs) with 95% confidence intervals (CIs).

resultsTwenty-two studies were included. Fifteen studies evaluating non-thyroidal illness syndrome (5,230 patients) showed a significant association with mortality (OR 3.19, 95% CI 2.10-4.85), although heterogeneity was substantial (I²=67.5%, p<0.0001). Nine studies evaluating isolated low triiodothyronine (6,282 patients) also demonstrated a significant association with mortality (OR 2.93, 95% CI: 2.04-4.20), with substantial heterogeneity (I²=63.8%, p = 0.0048). Subgroup comparison and exploratory meta-regression showed no significant differences in effect size between the two definitions of thyroid dysfunction.

conclusionsBoth non-thyroidal illness syndrome and isolated low triiodothyronine are associated with increased mortality in critically ill and cardiovascular patients. Although current aggregate data do not demonstrate a clear quantitative superiority of one definition over the other, non-thyroidal illness syndrome may provide a more integrated biological framework for interpreting thyroid dysfunction during acute illness.

Indexed as

Acute DiseaseCardiovascular DiseasesCritical IllnessEuthyroid Sick SyndromesTriiodothyronineBiomarkersHumansPrognosisBiomarkersTriiodothyronineacute illnessLow T3 syndromeNon-thyroidal illness syndromeprognosis

Identifiers

PMID42804119
PMCPMC13619638

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.