Clinical Outcomes of Thyroid Storm Treatment by High Versus Moderate Burch-Wartofsky score at In-hospitalized Patients at Buri Ram Hospital During 2017-2020

Abstract

Background: Thyroid storm or thyroid crisis has high mortality rate. Criteria for diagnostic thyroid storm is Burch-Wartofsky score (BWS) ≥45. No previous study had compare the clinical outcome of thyroid storm and level BWS. I hypothesized that a higher BWS is correlated with higher complications that need close observation.
Methods: To compare clinical outcome of treatment thyroid storm between two groups of BWS high versus moderate score.
Designs: The retrospective cohort study of hospitalized patients in the medical department, Buri Ram Hospital, Thailand during January 2017-December 2020. By searching the electronic medical record, a total of 74 adults patients aged between 18-80 years was included.
Objective: To compare two groups of thyroid storm that have high and moderate BWS and analysis by multivariable risk ratio regression.
Results: Seventy-four patients were diagnosed with thyroid storm. Female patients were more common. Mean age 49 years (±SD 13.3). Twenty-five patients have high BWS and forty-nine patients have moderate BWS. The high BWS has increased risk of death RR 6.46, increased risk of intubation RR 2.52, increased ICU administration RR 11.50 and increased risk of acute kidney injury RR 3.43
Conclusions: A higher BWS is correlated with higher complications that need close observation. But in limited resource BWS can be prioritized patients to ICU administration.