Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

National Trends: Thyrotoxicosis and Thyroid Storm

Thyroid; ePub 2018 Dec 18; Galindo, Hurtado, et al

1 of every 6 patients discharged for thyrotoxicosis was diagnosed with thyroid storm, according to a recent study. Furthermore, thyroid storm is associated with a 12-fold higher mortality rate compared to thyrotoxicosis without storm. A retrospective longitudinal analysis was conducted of clinical characteristics, mortality, hospital length of stay (LOS), and costs from 2004 to 2013. The study used data from the National Inpatient Sample database. Adults (aged ≥18 years) with a primary diagnosis of thyrotoxicosis with and without thyroid storm were included, Researchers found:

  • Among 121,384 discharges with thyrotoxicosis during the study period, 19,723 (16.2%) were diagnosed with thyroid storm.
  • During the past decade, the incidence of thyroid storm ranged between 0.57 and 0.76 cases/100,000 US persons per year, and 4.8 and 5.6/100,000 hospitalized patients per year.
  • Thyroid storm was associated with significantly higher hospital mortality (1.2–3.6% vs 0.1–0.4%) and longer LOS (4.8–5.6 vs 2.7–3.4 mean days) compared to patients with thyrotoxicosis without storm.
  • Inflation-adjusted hospitalization costs progressively increased in patients with thyroid storm from $9,942 to $12,660 between 2004 and 2013.

Galindo RJ, Hurtado CR, Pasquel FJ, García Tome R, Peng L, Umpierrez GE. National trends in incidence, mortality, and clinical outcomes of patients hospitalized for thyrotoxicosis with and without thyroid storm in the United States, 2004–2013. [Published online ahead of print December 18, 2018]. Thyroid. doi:10.1089/thy.2018.0275.