Prognostic factors and prognostic risk score of 30-day all-cause mortality in thyroid storm.

BACKGROUND

Thyroid storm is a life-threatening endocrine emergency with high mortality. Existing diagnostic score primarily focuses on diagnosis rather than predicting outcomes. This study aimed to identify prognostic factors and develop a practical clinical prognostic score for 30-day all-cause mortality in patients with thyroid storm.

METHODS

A retrospective cohort study was conducted at a tertiary care center in Thailand. Patients diagnosed with thyroid storm were included. To identify prognostic factors of 30-day all-cause mortality, clinical and biochemical variables were analyzed using multivariable logistic regression analysis presented with odds ratio (OR). A prognostic risk score was developed and internally validated using bootstrapping. Statistical significance p-value was set at < 0.05.

RESULTS

A total of 115 patients were included, with a 30-day mortality rate of 13%. Significant prognostic factors of 30-day mortality included male sex (OR 4.34), hypertension (OR 2.54), SOFA score ≥ 2 (OR 9.93), and GCS ≤ 10 (OR 1.95). Based on these four variables, a weighted scoring system (total 8 points) was developed. The model demonstrated good discriminatory performance with an apparent AUC of 0.81, which remained robust at 0.79 (95% CI 0.69-0.91) after internal validation via bootstrapping.

CONCLUSION

The prognostic factors and proposed clinical prognostic score, incorporating simple and readily available parameters, provides an effective tool for early risk stratification in thyroid storm. This score can facilitate prioritized intensive care admission. Further external validation is warranted to confirm its generalizability across diverse clinical settings.

CLINICAL TRIAL NUMBER: Not applicable.