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

Area of Science:

• Endocrinology
• Internal Medicine
• Critical Care Medicine

Background:

• Thyroid storm (TS) is associated with a high mortality rate, historically exceeding 10%.
• Evaluating current management strategies is crucial for improving patient outcomes in TS.

Purpose of the Study:

• To assess the effectiveness of the 2016 guidelines for TS management.
• To determine if adherence to these guidelines impacts patient prognosis.

Main Methods:

• A prospective, multicenter, registry-based study involving 110 new-onset TS patients.
• Data collected via the Research Electronic Data Capture (REDCap) platform over 180 days.
• Analysis of clinical information, prognosis, and adherence to guidelines.

Main Results:

• Despite higher disease severity (median APACHE II score 13 vs. 10), 30-day mortality was 5.5%, a significant reduction from previous studies.
• Factors associated with poor prognosis included lower BMI, shock, and reduced left ventricular ejection fraction.
• Mortality was substantially higher (50% vs. 4.7%) in patients with APACHE II score ≥12 who did not follow guidelines.

Conclusions:

• The 2016 TS management guidelines appear effective in improving patient prognosis.
• Adherence to the guidelines is associated with a lower mortality rate.
• The guidelines offer a valuable framework for managing thyroid storm effectively.