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Hospital Outcomes Worse With Suboptimal Treatment of Hypothyroidism

Patients with clinical hypothyroidism and a high prehospitalization TSH level had longer length of stay, increased risk for readmission

THURSDAY, April 28, 2022 (HealthDay News) — Suboptimal treatment of hypothyroidism is associated with worse hospital outcomes, according to a study published online April 26 in the Journal of Clinical Endocrinology & Metabolism.

Matthew D. Ettelson, M.D., from the University of Chicago, and colleagues conducted a retrospective cohort study to identify differences in hospital outcomes between patients with and without hypothyroidism using data from a U.S.-based commercial claims database from Jan. 1, 2008, to Dec. 31, 2015. Participants were aged 64 years and younger and had a thyrotropin (TSH) level collected prior to hospital admission. Patients with hypothyroidism were classified into four subgroups according to prehospitalization TSH level.

The final study population included 43,478 patients, of whom 8,873 had a diagnosis of hypothyroidism. The researchers found that patients with a high prehospitalization TSH level (TSH >10.00 mIU/L) had a length of stay that was 1.2 days longer and had an increased risk for 30- and 90-day readmission compared with balanced controls (relative risks, 1.49 and 1.43, respectively). Reduced risks for in-hospital mortality and 90-day readmission were seen for patients with normal TSH levels (relative risks, 0.46 and 0.92, respectively).

“It is important for both patients and physicians to know that maintaining optimal thyroid hormone replacement is important to minimize length of hospital stays and hospital readmission,” Ettelson said in a statement. “It is particularly important for planned admissions where thyroid hormone replacement can be adjusted if needed prior to admission.”

One author disclosed financial ties to the pharmaceutical industry.

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