In-Hospital Mortality and Morbidity Linked to Protein Caloric Malnutrition in Thyrotoxicosis

Ventilator monitor ,given oxygen by intubation tube to patient, setting in ICU/Emergency room
A team of investigators conducted a retrospective cohort study to determine the effect of protein caloric malnutrition on morbidity, mortality, and length of hospital stay in patients with thyrotoxicosis.

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Protein caloric malnutrition (PCM) in hospitalized patients with thyrotoxicosis was found to be associated with increased risk of mortality and morbidity as well as longer hospital stays and associated costs, according to the results of a study presented at the 30th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (ENVISION 2021).

Investigators of this retrospective cohort study sought to determine the effect of PCM on hospitalized patients with thyrotoxicosis in terms of morbidity, mortality, and hospital stay. Using data from the 2017 Nationwide Inpatient Sample, 155,964 patients with thyrotoxicosis as a primary diagnosis were identified and stratified based on PCM status. Analyses were adjusted for potential confounding variables.

Of 155,964 patients hospitalized with thyrotoxicosis, 11,325 were identified as having PCM. Patients with thyrotoxicosis and PCM had a higher rate of in-hospital mortality compared with patients without PCM (4.77% vs 1.57%; P =.018). In addition, patients with thyrotoxicosis and PCM had longer hospital stays (8.8 days vs 4.7 days) and higher hospital costs ($92,286 vs $51,078).

In adjusted analyses, the thyrotoxicosis and PCM group also was associated with greater risk of all-cause mortality (adjusted odds ratio [AOR] 2.30; 95% CI, 1.83-2.94; P <.001), sepsis (AOR 2.83; 95% CI, 2.41-3.32; P <.001), pneumonia (AOR 1.69; 95% CI, 1.47-1.94; P <.001), mechanical ventilation (AOR 1.37; 95% CI, 1.07-1.76; P =.012), and acute kidney injury (AOR 1.57; 95% CI, 1.40-1.77; P <.001).

The researchers concluded that patients hospitalized for thyrotoxicosis and PCM had considerably higher in-hospital mortality rates, longer hospital stays, and higher hospital costs. They further indicated that the risks for all-cause mortality, sepsis, pneumonia, acute kidney injury, and need for mechanical ventilation were also higher among this patient group.

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Ramirez M, Atluri R, Bustos K, Shaka H. Protein caloric malnutrition is associated with higher mortality in patients admitted with thyrotoxicosis. Presented at: 2021 AACE Virtual Annual Meeting, May 26-29, 2021.