Potassium Iodide Use and Patient Outcomes for Thyroid Storm: An Observational Study.
Yuichiro Matsuo1, Atsushi Miyawaki1,2, Hideaki Watanabe1
1Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, 113-8655, Japan.
The Journal of Clinical Endocrinology and Metabolism
|March 28, 2024
Summary
Early potassium iodide (KI) may reduce mortality in thyroid storm patients with Graves' disease. This study found shorter hospital stays and lower costs with KI use.
Area of Science:
- Endocrinology
- Internal Medicine
- Pharmacology
Background:
- Clinical guidelines suggest iodine with antithyroid drugs for thyroid storm.
- The specific efficacy of iodine in thyroid storm management is not well-established.
Purpose of the Study:
- To investigate the association between early potassium iodide (KI) administration and in-hospital mortality in thyroid storm patients.
- To analyze the impact of KI on length of stay and hospitalization costs.
Main Methods:
- Retrospective analysis of the Japanese Diagnosis Procedure Combination database (July 2010-March 2022).
- Comparison of in-hospital mortality, length of stay, and costs between patients receiving KI within 2 days of admission and those who did not.
- Subgroup analyses were conducted for patients with and without Graves' disease.
Main Results:
- Among 3188 patients, 2350 received early KI. Crude mortality was 6.1% (KI group) vs 7.8% (non-KI group).
- Adjusted analysis showed no significant association between KI and overall mortality (OR, 0.91).
- In Graves' disease patients, KI was associated with lower mortality (OR, 0.46). No significant difference was observed in non-Graves' disease patients (OR, 1.11).
- KI group had shorter length of stay and lower total hospitalization costs.
Conclusions:
- Potassium iodide (KI) may decrease in-hospital mortality in thyroid storm patients diagnosed with Graves' disease.
- Early KI use is linked to reduced length of stay and hospitalization costs.
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