Prospective Multicenter Registry-Based Study on Thyroid Storm: The Guidelines for Management From Japan Are Useful.

Autor:	Furukawa Y; First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan., Tanaka K; Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan., Isozaki O; Wakamatsukawada Clinic, Tokyo 162-0054, Japan., Suzuki A; Department of Endocrinology, Diabetes and Metabolism, Fujita Health University, Aichi 470-1192, Japan., Iburi T; Diabetes, Endocrinology, and Metabolism, Takashimadaira Chuo General Hospital, Tokyo 175-0082, Japan., Tsuboi K; Division of Diabetes, Metabolism and Endocrinology, Department of Medicine, Toho University School of Medicine, Tokyo 143-8540, Japan., Iguchi M; Department of Cardiac Rehabilitation, National Hospital Organization Kyoto Medical Center, Kyoto 612-0861, Japan., Kanamoto N; Department of Endocrinology, Osaka City General Hospital, Osaka 534-0021, Japan., Minamitani K; Department of Pediatrics, Teikyo University Chiba Medical Center, Chiba 299-0112, Japan., Wakino S; Department of Nephrology, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8503, Japan., Satoh T; Jounan Clinic, Gunma 370-0846, Japan., Teramukai S; Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan., Kimura E; Department of Medical Informatics, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan., Miyake Y; Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan., Akamizu T; First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan.; Department of Internal Medicine, Kuma Hospital, Kobe 650-0011, Japan.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2024 Dec 18; Vol. 110 (1), pp. e87-e96.
DOI:	10.1210/clinem/dgae124
Abstrakt:	Context: The mortality rate in thyroid storm (TS) has been reported to be higher than 10%. Objective: We aimed to evaluate the effectiveness of the 2016 guidelines for the management of TS proposed by the Japan Thyroid Association and Japan Endocrine Society. Methods: In this prospective multicenter registry-based study, patients with new-onset TS were registered in the Research Electronic Data Capture (REDCap), a secure web platform. On day 30 after admission, clinical information and prognosis of each patient were added to the platform. On day 180, the prognosis was described. Results: This study included 110 patients with TS. The median of Acute Physiology and Chronic Health Evaluation (APACHE) II score was 13, higher than the score (10) in the previous nationwide epidemiological study (P = .001). Nonetheless, the mortality rate at day 30 was 5.5%, approximately half compared with 10.7% in the previous nationwide survey. Lower body mass index, shock, and lower left ventricular ejection fraction were positively associated with poor prognosis at day 30, while the lack of fever ≥ 38 °C was related to the outcome. The mortality rate in patients with an APACHE II score ≥ 12 for whom the guidelines were not followed was significantly higher than the rate in patients for whom the guidelines were followed (50% vs 4.7%) (P = .01). Conclusion: Prognosis seemed better than in the previous nationwide survey, even though disease severity was higher. The mortality rate was lower when the guidelines were followed. Thus, the guidelines are useful for managing TS. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)
Databáze:	MEDLINE
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