ลักษณะทางคลินิกและปัจจัยเสี่ยงที่สัมพันธ์กับการเสียชีวิตในผู้ป่วยที่ได้รับการวินิจฉัยไทรอยด์เป็นพิษวิกฤตในโรงพยาบาลสวรรค์ประชารักษ์

Duanghathai  Wattanakul

Authors

Duanghathai Wattanakul Sawanpracharak Hospital

Keywords:

Thyroid storm, Clinical Characteristics, Risk factors, Mortality

Abstract

Objective: To study the clinical characteristics and risk factors associated with mortality in patients diagnosed with thyroid storms and the time required to initiate treatment and utilization of the intensive care unit in patients diagnosed with thyroid storms at Sawanpracharak Hospital.

Method: A retrospective observational study of 145 patients diagnosed with thyroid storm who were hospitalized at Sawanpracharak Hospital from October 1, 2015, to May 31, 2024. Data were collected from inpatient medical records, including general clinical characteristics, thyroid storm diagnosis, and assessment using the Burch-Wartofsky Point Scale (BWPS) and/or the Diagnostic Criteria for Thyroid Storm of the Japanese Thyroid Association (JTA Criteria). The study also examined comorbid conditions at admission, laboratory findings, treatment modalities, and hospital length of stay. Clinical characteristics and risk factors associated with mortality were analyzed using Chi-square tests, and multivariable logistic regression was used to determine adjusted odds ratios with 95% confidence intervals (CI). A p-value < 0.05 was considered statistically significant.

Results: 145 patients were diagnosed with thyroid storm, with a mean age of 52.78 ±1.3 years. The majority were female (100 patients, 68.9%). The overall mortality rate was 36.6%. Early treatment within 24 hours of hospital admission was received by 22.1% of patients. Multivariable logistic regression data analysis showed that factors that significantly affected mortality include disseminated intravascular coagulation (DIC) (Adjusted Odds Ratio = 23.08; 95% CI: 2.20-23.60), acute kidney injury (AKI) (Adjusted Odds Ratio = 4.58; 95% CI: 1.60-12.5) and hypoglycemia (Adjusted Odds Ratio = 15.31; 95% CI: 2.60-89.60)

Conclusions: Factors associated with mortality in patients diagnosed with thyroid storm include disseminated intravascular coagulation (DIC), acute kidney injury (AKI), and hypoglycemia

Keywords: Thyroid storm, Clinical Characteristics, Risk factors, Mortality

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