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This retrospective cohort study evaluated perioperative changes in free T3 (FT3), free thyroxine (FT4), and TSH, and assessed associations with morbidity and mortality. Serum thyroid markers were measured before surgery and within one hour of cardiac ICU admission in 132 neonates. Postoperative FT3 and TSH declined significantly, FT3 correlated with ventilation duration and length of stay, and lower FT3 independently predicted mortality.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/early-decline-in-thyroid-hormone-levels-predicts-mortality-following-congenital-heart-surgery-in-neonates-a-retrospective-cohort-study/465309/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/early-decline-in-thyroid-hormone-levels-predicts-mortality-following-congenital-heart-surgery-in-neonates-a-retrospective-cohort-study/465309.png","ImageObject",300,407,{"name":92,"@type":93},"Margaret","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Which thyroid hormones were measured and when in the study?","Question",{"text":113,"@type":114},"FT3, FT4, and TSH were measured preoperatively and within one hour after admission to the cardiac intensive care unit.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What postoperative thyroid hormone changes were reported?",{"text":118,"@type":114},"Postoperatively, FT3 and TSH levels declined significantly, while FT4 remained unchanged.",{"name":120,"@type":111,"acceptedAnswer":121},"How was mortality associated with postoperative FT3?",{"text":122,"@type":114},"Lower postoperative FT3 levels were significantly associated with mortality, and postoperative FT3 was independently linked to mortality in multivariable logistic regression.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},465309,1791015079,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},137451207643,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Article  \nEarly Decline in Thyroid Hormone Levels Predicts Mortality Following Congenital Heart Surgery in Neonates: A Retrospective Cohort Study  \nDuygu Tunçel 1, *, Süleyman Geter 2, Leyla ¸Sero 2, Nilüfer Okur 1 and Osman Akdeniz 3  \nAcademic Editor: Søren Møller  \nReceived: 24 November 2025  \nRevised: 19 December 2025  \nAccepted: 22 December 2025  \nPublished: 25 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Pediatrics, Division of Neonatology, SBU Gazi Yasargil Training and Research Hospital, 21010 Diyarbakır, Turkey; [nilufermatur.okur@saglik.com](nilufermatur.okur@saglik.com)  \n2 Department of Pediatrics, SBU Gazi Yasargil Training and Research Hospital, 21010 Diyarbakır, Turkey; [sgeter21@gmail.com](sgeter21@gmail.com) (S.G.); [ozlemleylasero@gmail.com](ozlemleylasero@gmail.com) (L. ¸S.)  \n3 Department of Pediatric Cardiyology, SBU Gazi Ya¸sargil Training and Research Hospital,  \n21010 Diyarbakır, Turkey; [osman_akdeniz@hotmail.com](osman_akdeniz@hotmail.com)  \n* Correspondence: [duygu.tuncel1@saglik.gov.tr](duygu.tuncel1@saglik.gov.tr)  \nAbstract  \nBackground: Thyroid hormone dysregulation is a well-recognized consequence of cardiopulmonary bypass (CPB), particularly in neonates undergoing congenital heart surgery. Triiodothyronine (T3) plays a crucial role in maintaining cardiovascular stability, and an early decline in serum levels may adversely impact clinical outcomes. This study aimed to evaluate perioperative thyroid hormone changes and their association with morbidity and mortality. Methods: We retrospectively analyzed 132 neonates who underwent congenital cardiac surgery with CPB between January 2021 and June 2024 . Serum free T3 (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) levels were measured preoperatively and within one hour after admission to the cardiac intensive care unit. Demographic, clinical, and surgical variables were recorded. Associations between thyroid hormone levels and postoperative outcomes, including in-hospital mortality, ventilation duration, vasoactive-inotropic score (VIS), and length of stay, were assessed using correlation analyses, logistic regression, and receiver operating characteristic (ROC) analysis. Results: Postoperatively, both FT3 and TSH levels declined significantly (p \u003C 0.01), while FT4 levels remained unchanged. Lower postoperative FT3 levels were negatively correlated with prolonged invasive mechanical ventilation (rho = −0.196, p = 0.029) and longer hospital stay (rho = −0.183, p = 0.042) . Overall mortality was 7.6%(n = 10) . Non-survivors had significantly lower postoperative FT3 levels compared with survivors (p = 0.001) . In multivariable logistic regression, postoperative FT3 was independently associated with mortality (OR = 0.22, 95% CI 0.05–1.03, p = 0.048) . ROC analysis demonstrated good predictive performance of postoperative FT3 for mortality (AUC = 0.818), with an optimal cutoff of 2.17 pg/mL (sensitivity 72%, specificity 70%) . Conclusions: Early postoperative suppression of FT3 is common after CPB in neonates and is independently associated with increased mortality and adverse short-term outcomes. Early assessment of thyroid function, particularly FT3, may provide valuable prognostic information and aid in risk stratification in this high-risk population.  \nKeywords: congenital heart surgery; FT3; FT4; TSH; neonates; cardiopulmonary bypass  \n1. Introduction  \nThyroid function in neonates with congenital heart disease undergoing cardiopulmonary bypass (CPB) is a critical area of research. Cardiopulmonary bypass affects normal homeostasis, especially during the neonatal period, and has significant effects on thyroid function [1,2] . The thyroid gland plays a vital role in regulating metabolism and cardiovascular function, which is particularly impo","cbCail3pFDeVMPX2","https://ap.wps.com/l/cbCail3pFDeVMPX2","pdf",526774,11,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# 1. Introduction","[{\"question\":\"Which thyroid hormones were measured and when in the study?\",\"answer\":\"FT3, FT4, and TSH were measured preoperatively and within one hour after admission to the cardiac intensive care unit.\"},{\"question\":\"What postoperative thyroid hormone changes were reported?\",\"answer\":\"Postoperatively, FT3 and TSH levels declined significantly, while FT4 remained unchanged.\"},{\"question\":\"How was mortality associated with postoperative FT3?\",\"answer\":\"Lower postoperative FT3 levels were significantly associated with mortality, and postoperative FT3 was independently linked to mortality in multivariable logistic regression.\"}]","Early Decline in Thyroid Hormone Levels Predicts Mortality Following Congenital Heart Surgery in Neonates - A Retrospective Cohort Study | PDF",1790769462,28]