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Trends in the Incidence and In-Hospital Outcomes of Cardiogenic Shock Complicating Thyroid Storm.

Abstract Thyroid storm (TS) constitutes an endocrine emergency with an incidence of up to 10% of all admissions for thyrotoxicosis. Cardiogenic shock (CS) is a rare complication of TS and very limited data exists on its incidence and outcomes. We aimed to estimate the national trends in incidence and outcomes of CS among patients admitted to US hospitals with TS.
PMID
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Authors

Mayor MeshTerms
Keywords

Cardiogenic shock

Congestive heart failure

Thyroid storm

Journal Title the american journal of the medical sciences
Publication Year Start




PMID- 28864374
OWN - NLM
STAT- MEDLINE
DA  - 20170902
DCOM- 20170908
LR  - 20170908
IS  - 1538-2990 (Electronic)
IS  - 0002-9629 (Linking)
VI  - 354
IP  - 2
DP  - 2017 Aug
TI  - Trends in the Incidence and In-Hospital Outcomes of Cardiogenic Shock
      Complicating Thyroid Storm.
PG  - 159-164
LID - S0002-9629(17)30229-X [pii]
LID - 10.1016/j.amjms.2017.04.017 [doi]
AB  - BACKGROUND: Thyroid storm (TS) constitutes an endocrine emergency with an
      incidence of up to 10% of all admissions for thyrotoxicosis. Cardiogenic shock
      (CS) is a rare complication of TS and very limited data exists on its incidence
      and outcomes. We aimed to estimate the national trends in incidence and outcomes 
      of CS among patients admitted to US hospitals with TS. MATERIALS AND METHODS: We 
      queried the nationwide inpatient sample for patients with the discharge diagnosis
      of TS between the years of 2003 and 2011. RESULTS: Based on a weighted estimate, 
      we identified 41,835 patients with a diagnosis of TS, of which 1% developed CS.
      Patients with CS were more likely to have history of atrial fibrillation, alcohol
      abuse, preexisting congestive heart failure, coagulopathy, drug use, liver
      disease, pulmonary circulation disorders, valvular disorders, weight loss, renal 
      failure, fluid and electrolyte disorders as compared to those who did not develop
      CS (P < 0.001 for all). We observed an increase in incidence of CS from 0.5% in
      2003 to 3% in 2011 and a decrease in mortality from 60.5% in 2003 to 20.9% in
      2011 (Ptrend < 0.001 for both). CONCLUSIONS: We observed that CS is a rare
      complication of TS, which occurs more commonly in male patients with preexisting 
      structural and atherosclerotic heart disease, and carries a very poor prognosis. 
      Although incidence has increased over the years, mortality from CS has steadily
      declined.
CI  - Copyright (c) 2017 Southern Society for Clinical Investigation. Published by
      Elsevier Inc. All rights reserved.
FAU - Mohananey, Divyanshu
AU  - Mohananey D
AD  - Division of Hospital Medicine, Cleveland Clinic, Cleveland, Ohio. Electronic
      address: [email protected]
FAU - Smilowitz, Nathaniel
AU  - Smilowitz N
AD  - Division of Cardiology, New York University School of Medicine, New York, New
      York.
FAU - Villablanca, Pedro A
AU  - Villablanca PA
AD  - Division of Cardiovascular Diseases, Montefiore Medical Center/Albert Einstein
      College of Medicine, Bronx, New York.
FAU - Bhatia, Nirmanmoh
AU  - Bhatia N
AD  - Division of Cardiovascular Medicine, Vanderbilt Heart and Vascular Institute,
      Vanderbilt University Medical Center, Nashville, Tennessee.
FAU - Agrawal, Sahil
AU  - Agrawal S
AD  - Department of Cardiovascular Medicine, St. Lukes University Health Network,
      Bethlehem, Pennsylvania.
FAU - Baruah, Anushka
AU  - Baruah A
AD  - Department of Medicine, John H Stroger Hospital of Cook County, Chicago,
      Illinois.
FAU - Ali, Muhammad S
AU  - Ali MS
AD  - Division of Pulmonary, Critical Care & Sleep Medicine, Medical College of
      Wisconsin, Milwaukee, Wisconsin.
FAU - Bangalore, Sripal
AU  - Bangalore S
AD  - Division of Cardiology, New York University School of Medicine, New York, New
      York.
FAU - Ramakrishna, Harish
AU  - Ramakrishna H
AD  - Department of Anesthesiology, Mayo Clinic, Phoenix, Arizona.
LA  - eng
PT  - Journal Article
DEP - 20170425
PL  - United States
TA  - Am J Med Sci
JT  - The American journal of the medical sciences
JID - 0370506
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Shock, Cardiogenic/diagnosis/*epidemiology/*etiology/mortality
MH  - Thyroid Crisis/*complications/diagnosis/*epidemiology/mortality
MH  - United States/epidemiology
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Congestive heart failure
OT  - Thyroid storm
EDAT- 2017/09/03 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/09/03 06:00
PHST- 2017/01/17 [received]
PHST- 2017/04/17 [revised]
PHST- 2017/04/21 [accepted]
AID - S0002-9629(17)30229-X [pii]
AID - 10.1016/j.amjms.2017.04.017 [doi]
PST - ppublish
SO  - Am J Med Sci. 2017 Aug;354(2):159-164. doi: 10.1016/j.amjms.2017.04.017. Epub
      2017 Apr 25.