Why the study?
Cardiogenic shock occurs in 1% of patients with thyroid storm and is associated with poor prognosis.
In patients with thyroid storm, factors such as history of heart failure, elevated pro-BNP, and interstitial edema on chest x-ray can help risk-stratify for cardiogenic shock, which is associated with markedly increased in-hospital mortality.
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Findings support risk stratification for cardiogenic shock in thyroid storm; hypothesis-generating and requires prospective validation.
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.
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Pink et al. (2023) studied this question.
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