Risk factors for cardiogenic shock in thyroid storm: a retrospective and case-series study

Future Cardiol. 2023 Sep;19(12):605-613. doi: 10.2217/fca-2023-0043. Epub 2023 Oct 13.

Abstract

Aim: Thyroid storm (TS) occurs in 10% of thyrotoxicosis patients and 1% of TS patients experience cardiogenic shock (CS), which is associated with poor prognosis. Methods: This is a single institution, retrospective study in which 56 patients with TS were evaluated. Results: BMI (p = 0.002), history of heart failure (OR 8.33 [1.91, 36.28]; p = 0.004), pro-BNP elevation (p = 0.04), chest x-ray showing interstitial edema (OR 3.33 [1.48, 7.52]; p = 0.01) and Burch-Wartofsky score (62.5 vs 40; p = 0.004) showed association with CS. CS patients had increased length of stay (16.5 vs 4 days; p = 0.01) and higher in-hospital mortality (OR 24.5 [2.90, 207.29]; p < 0.001). Conclusion: These risk factors are useful to risk stratify TS patients on admission, institute therapy in a timely manner and decrease mortality.

Keywords: cardiogenic shock; congestive heart failure; mortality; risk stratification; thyroid storm; thyrotoxicosis.

MeSH terms

  • Hospital Mortality
  • Humans
  • Patient Admission
  • Retrospective Studies
  • Risk Factors
  • Shock, Cardiogenic / epidemiology
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy
  • Thyroid Crisis* / complications
  • Thyroid Crisis* / diagnosis