直近一年間の累計
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ID 119548
著者
Furukawa, Yasushi Wakayama Medical University
Tanaka, Keiko Ehime University
Isozaki, Osamu Wakamatsukawada Clinic
Suzuki, Atsushi Fujita Health University
Iburi, Tadao Takashimadaira Chuo General Hospital
Tsuboi, Kumiko Toho University
Iguchi, Moritake National Hospital Organization Kyoto Medical Center
Kanamoto, Naotetsu Osaka City General Hospital
Minamitani, Kanshi Teikyo University
Satoh, Tetsurou Jounan Clinic
Teramukai, Satoshi Kyoto Prefectural University of Medicine
Kimura, Eizen Ehime University
Miyake, Yoshihiro Ehime University
Akamizu, Takashi Wakayama Medical University|Kuma Hospital
キーワード
epidemiology
prospective
REDCap
thyroid crisis
Graves disease
thyrotoxicosis
資料タイプ
学術雑誌論文
抄録
Context: The mortality rate in thyroid storm (TS) has been reported to be higher than 10%.
Objective: We aimed to evaluate the effectiveness of the 2016 guidelines for the management of TS proposed by the Japan Thyroid Association and Japan Endocrine Society.
Methods: In this prospective multicenter registry–based study, patients with new-onset TS were registered in the Research Electronic Data Capture (REDCap), a secure web platform. On day 30 after admission, clinical information and prognosis of each patient were added to the platform. On day 180, the prognosis was described.
Results: This study included 110 patients with TS. The median of Acute Physiology and Chronic Health Evaluation (APACHE) II score was 13, higher than the score (10) in the previous nationwide epidemiological study (P = .001). Nonetheless, the mortality rate at day 30 was 5.5%, approximately half compared with 10.7% in the previous nationwide survey. Lower body mass index, shock, and lower left ventricular ejection fraction were positively associated with poor prognosis at day 30, while the lack of fever ≥ 38 °C was related to the outcome. The mortality rate in patients with an APACHE II score ≥ 12 for whom the guidelines were not followed was significantly higher than the rate in patients for whom the guidelines were followed (50% vs 4.7%) (P = .01).
Conclusion: Prognosis seemed better than in the previous nationwide survey, even though disease severity was higher. The mortality rate was lower when the guidelines were followed. Thus, the guidelines are useful for managing TS.
掲載誌名
The Journal of Clinical Endocrinology & Metabolism
ISSN
19457197
0021972X
cat書誌ID
AA00695484
AA1203774X
出版者
The Endocrine Society|Oxford University Press
開始ページ
dgae124
発行日
2024-03-08
権利情報
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited.
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出版社版DOI
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言語
eng
著者版フラグ
出版社版
部局
医学系