Predictors of Outcome in Myxoedema Coma
Author Information
Author(s): Pinaki Dutta, Anil Bhansali, Shriq Rashid Masoodi, Sanjay Bhadada, Navneet Sharma, Rajesh Rajput
Primary Institution: Postgraduate Institute of Medical Education and Research, Chandigarh, India
Hypothesis
What are the predictors of outcome in patients with myxoedema coma?
Conclusion
Patients who were non-compliant with L-thyroxine treatment had more severe manifestations and higher mortality compared to those diagnosed for the first time.
Supporting Evidence
- Patients who stopped L-thyroxine treatment presented earlier with more severe symptoms.
- Sepsis was the major accompanying comorbidity in 74% of patients.
- SOFA score was found to be the best predictor of mortality.
Takeaway
This study looked at patients with a serious condition called myxoedema coma and found that those who didn't take their medicine had worse symptoms and were more likely to die.
Methodology
This was a prospective observational study analyzing 23 patients with myxoedema coma, measuring thyroid function and various scores to predict outcomes.
Potential Biases
Potential bias due to the observational nature of the study and reliance on historical data.
Limitations
The study had a small sample size and was conducted at a single center.
Participant Demographics
The study included 23 patients, predominantly elderly women (87%) with a mean age of 59.5 years.
Statistical Information
P-Value
p = 0.01 for hypotension, p = 0.03 for bradycardia, p = 0.00 for mechanical ventilation, p = 0.01 for unresponsive hypothermia, p = 0.01 for sepsis, p = 0.02 for sedative drugs, p = 0.03 for lower GCS, p = 0.04 for high APACHE II score, p = 0.00 for high SOFA score.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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