Endocrine Abstracts

Objective: The British Thyroid Association (BTA) published guidelines for thyroid function testing (TFTs) in June 2006, recommending that TFTs should not be requested for acute medical patients in the absence of specific clinical indications. This audit assesses the proportion of thyroid function tests performed on acute medical inpatients that are indicated.

Design: Retrospective data collection on 205 sequential thyroid function tests performed over 3 months on acute medical inpatients.

Setting: Seven hundred and eighty bed district general hospital.

Results: TFTs were requested with appropriate indications in 121 (59%) patients. The most common indication for TFTs was atrial flutter or fibrillation (n=76, 37%). Of the 84 inappropriate tests, 26 (31%) were due to TFTs having been performed in the preceding month, whilst there were a number of common inappropriate reasons for requesting TFTs including chest pain, shortness of breath, DVT and stroke. There was no significant difference between the number of abnormal results in the appropriately (n=23, 19%) vs inappropriately (n=18, 21%) requested tests. Only 1 new case of thyroid disease was identified amongst the 205 tests performed.

Conclusion: Of TFTs requested in acute medical inpatients in our hospital, 41% were not indicated according to BTA guidelines, with only a single new case of thyroid disease being identified in our sample of 205 patients. Our audit reinforces the principle that TFT results very rarely influence the management of acutely unwell medical inpatients, and should not be performed routinely in this patient group.