Cardiovascular Events in Patients With Thyroid Storm

Zainulabedin Waqar; Sindhu Avula; Jay Shah; Syed Sohail Ali


J Endo Soc. 2021;5(6) 

In This Article


The study cohort was derived from the National Inpatient Sample (NIS) database collected from January 2012 to September 2015, which is derived from the Healthcare Cost and Utilization Project (HCUP) and sponsored by the Agency for Healthcare Research and Quality. Thyroid storm as primary diagnosis was identified using International Classification of Diseases, Clinical Modification (ICD-9-CM) codes (242.91, 242.01, 242.11, 242.21, 242.31, 242.41, 242.81). A total of 6830 adult hospitalizations with thyroid storm as the primary diagnosis were included in the final analysis, as depicted in Figure 1. A total of 3895 cases were found to have thyroid storm hospitalizations that included CEs (defined as ischemia, acute heart failure, and/or arrhythmia) and were compared with the remaining 2935 thyroid storm hospitalizations that did not have any documented CEs. Of the 3895 hospitalizations, 150 were found to be hospitalizations with ischemic events, 555 hospitalizations were associated with acute heart failure documented, and 3770 hospitalizations were documented with arrhythmia.

Figure 1.

Selection criteria from using the NIS database. Also describing the subclassification of patients with cardiovascular events and thyroid storm and the division in acute ischemic events, acute heart failure, and arrhythmias.

SAS software was used to convert the NIS database data to generate patient data by the HCUP recommendations and was performed using multivariate analysis.

The extracted thyroid storm hospitalizations were additionally classified by gender, race, comorbidities, household income, admission type, and hospital demographics. Patients were also categorized by their insurance status and type to identify Medicare and Medicaid recipients. The admitting hospitals were classified as rural, urban, teaching, and nonteaching hospitals based on the number of beds. Hospitals were organized by geographical locations as follows: the northeast, northwest, southern, and western regions. Admissions were also classified as either elective or emergent and/or urgent, where emergent and urgent were combined in our analysis. In-hospital mortality was determined based on patient expiring prior to discharge.