Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan
Background: Myxedema coma is a life-threatening and emergency presentation of hypothyroidism. However, the clinical features and outcomes of this condition have been poorly defined because of its rarity. Methods: We conducted a retrospective observational study of patients diagnosed with myxedema...
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| Format: | Article |
| Language: | English |
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Japan Epidemiological Association
2017-04-01
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| Series: | Journal of Epidemiology |
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| Online Access: | https://www.jstage.jst.go.jp/article/jea/27/3/27_27_117/_pdf |
| _version_ | 1818833740410912768 |
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| author | Yosuke Ono |
| author_facet | Yosuke Ono |
| author_sort | Yosuke Ono |
| collection | DOAJ |
| description | Background: Myxedema coma is a life-threatening and emergency presentation of hypothyroidism. However, the clinical features and outcomes of this condition have been poorly defined because of its rarity.
Methods: We conducted a retrospective observational study of patients diagnosed with myxedema coma from July 2010 through March 2013 using a national inpatient database in Japan. We investigated characteristics, comorbidities, treatments, and in-hospital mortality of patients with myxedema coma.
Results: We identified 149 patients diagnosed with myxedema coma out of approximately 19 million inpatients in the database. The mean (standard deviation) age was 77 (12) years, and two-thirds of the patients were female. The overall proportion of in-hospital mortality among cases was 29.5%. The number of patients was highest in the winter season. Patients treated with steroids, catecholamines, or mechanical ventilation showed higher in-hospital mortality than those without. Variations in type and dosage of thyroid hormone replacement were not associated with in-hospital mortality. The most common comorbidity was cardiovascular diseases (40.3%). The estimated incidence of myxedema coma was 1.08 per million people per year in Japan. Multivariable logistic regression analysis revealed that higher age and use of catecholamines (with or without steroids) were significantly associated with higher in-hospital mortality.
Conclusions: The present study identified the clinical characteristics and outcomes of patients with myxedema coma using a large-scale database. Myxedema coma mortality was independently associated with age and severe conditions requiring treatment with catecholamines. |
| first_indexed | 2024-12-19T02:23:44Z |
| format | Article |
| id | doaj.art-40147ee6f1324279974218bf4b820cc5 |
| institution | Directory Open Access Journal |
| issn | 0917-5040 1349-9092 |
| language | English |
| last_indexed | 2024-12-19T02:23:44Z |
| publishDate | 2017-04-01 |
| publisher | Japan Epidemiological Association |
| record_format | Article |
| series | Journal of Epidemiology |
| spelling | doaj.art-40147ee6f1324279974218bf4b820cc52022-12-21T20:40:03ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922017-04-0127311712210.1016/j.je.2016.04.002Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in JapanYosuke OnoBackground: Myxedema coma is a life-threatening and emergency presentation of hypothyroidism. However, the clinical features and outcomes of this condition have been poorly defined because of its rarity. Methods: We conducted a retrospective observational study of patients diagnosed with myxedema coma from July 2010 through March 2013 using a national inpatient database in Japan. We investigated characteristics, comorbidities, treatments, and in-hospital mortality of patients with myxedema coma. Results: We identified 149 patients diagnosed with myxedema coma out of approximately 19 million inpatients in the database. The mean (standard deviation) age was 77 (12) years, and two-thirds of the patients were female. The overall proportion of in-hospital mortality among cases was 29.5%. The number of patients was highest in the winter season. Patients treated with steroids, catecholamines, or mechanical ventilation showed higher in-hospital mortality than those without. Variations in type and dosage of thyroid hormone replacement were not associated with in-hospital mortality. The most common comorbidity was cardiovascular diseases (40.3%). The estimated incidence of myxedema coma was 1.08 per million people per year in Japan. Multivariable logistic regression analysis revealed that higher age and use of catecholamines (with or without steroids) were significantly associated with higher in-hospital mortality. Conclusions: The present study identified the clinical characteristics and outcomes of patients with myxedema coma using a large-scale database. Myxedema coma mortality was independently associated with age and severe conditions requiring treatment with catecholamines.https://www.jstage.jst.go.jp/article/jea/27/3/27_27_117/_pdfMyxedemaThyroid hormonesIncidenceMortalityHypothyroidism |
| spellingShingle | Yosuke Ono Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan Journal of Epidemiology Myxedema Thyroid hormones Incidence Mortality Hypothyroidism |
| title | Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan |
| title_full | Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan |
| title_fullStr | Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan |
| title_full_unstemmed | Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan |
| title_short | Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan |
| title_sort | clinical characteristics and outcomes of myxedema coma analysis of a national inpatient database in japan |
| topic | Myxedema Thyroid hormones Incidence Mortality Hypothyroidism |
| url | https://www.jstage.jst.go.jp/article/jea/27/3/27_27_117/_pdf |
| work_keys_str_mv | AT yosukeono clinicalcharacteristicsandoutcomesofmyxedemacomaanalysisofanationalinpatientdatabaseinjapan |