Objective: Our aim was to investigate the relationship between TFT and all-cause and cardiovascular (CV) mortality in aged hospitalized patients. Patients and methods: A 7-yr prospective observational study was conducted. TFT were assessed at hospital admission and mortality was registered in the follow-up period. Four hundred and four patients older than 65 yr admitted to the Department of Geriatrics, Hospital General, Segovia, Spain for any reason during 2005. Main Outcome Measures: The study evaluated the association between TFT and mortality from allcauses and CV diseases. TSH, free thyroxine (FT4), and free triiodothyronine (FT3) were measured. In-hospital and total survival time, number of deaths and all-cause and CV mortality were registered until census date on January 1st, 2012. Results: During the study 323 patients (80%) died. Kaplan-Meier analysis showed that median survival time for all-cause mortality was significantly higher in patients in the first tertile of serum FT3, in the first tertile of TSH, and in the first tertile of serum FT4 concentrations. Multivariate adjusted Cox regression analysis showed that history of tumor disease (HR, 1.60; 95% CI 1.12-2.27, p<0.01), age (1.03; 1.01-1.05, p<0.01), and FT3 levels (0.73; 0.64-0.84, p<0.001) were significant factors related to all-cause mortality. Cause of death was known in 202 patients. 61 patients (30.2%) of this group died because of CV disease. Patients in the first tertile of TSH and FT3 exhibited a significantly poorer survival than patients in the second and third tertiles of both hormones. In adjusted Cox regression analysis FT3 was the most strong predictor of CV mortality (0.74; 0.63- 0.88, p<0.001). Conclusions: Derangements in TFT during hospitalization may influence long-term mortality in elderly patients. In particular low FT3 levels are significantly related to all-cause and CV mortality.
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