Shaka Hafeez, Salim Michael, DeHart Luke, El-Amir Zain, Wani Farah, Kichloo Asim
Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois.
Department of Internal Medicine, Mount Sinai Hospital, Chicago, Illinois.
Proc (Bayl Univ Med Cent). 2022 Aug 17;35(6):773-777. doi: 10.1080/08998280.2022.2106452. eCollection 2022.
The goal of this study was to examine healthcare burden, hospitalizations, mortality, and healthcare cost utilization from hyperthyroidism to further our understanding of the effect of changes in thyroid disease management over the past decade. This was a retrospective longitudinal trends study involving hospitalizations for hyperthyroidism in the US from 2008 to 2018. We trended crude hospitalization rate, estimated incidence of hospitalizations, trends in inpatient mortality rate, mean length of hospital stay, and mean total hospital cost of patients with hyperthyroidism. The number of hyperthyroid hospitalizations decreased from 12,689 in 2008 to 9110 in 2018 (28.2%) ( trend <0.001), with a decrease of crude hospitalization rate from 33 to 25 per 100,000 hospitalizations. The estimated incidence rate of hospitalization in patients with hyperthyroidism decreased from 441 to 288 per 100,000 adults with hyperthyroidism. There was, however, no difference in adjusted mortality in hospitalizations over the study period. Although there has been a significant reduction in hospitalizations due to hyperthyroidism in the US, there has been no significant change in mortality during hospitalizations. This may represent improving outpatient management of hyperthyroidism. However, this improvement has not translated to outcomes in the hospital setting.
本研究的目的是调查甲状腺功能亢进症的医疗负担、住院情况、死亡率和医疗费用利用情况,以加深我们对过去十年甲状腺疾病管理变化所产生影响的理解。这是一项回顾性纵向趋势研究,涉及2008年至2018年美国甲状腺功能亢进症的住院情况。我们分析了甲状腺功能亢进症患者的粗住院率、估计住院发病率、住院死亡率趋势、平均住院时间和平均总住院费用的趋势。甲状腺功能亢进症的住院人数从2008年的12,689例下降到2018年的9110例(下降28.2%)(趋势<0.001),粗住院率从每10万次住院33例降至25例。甲状腺功能亢进症患者的估计住院发病率从每10万名甲状腺功能亢进症成年人中的441例降至288例。然而,在研究期间,住院调整死亡率没有差异。尽管美国因甲状腺功能亢进症导致的住院人数显著减少,但住院期间的死亡率没有显著变化。这可能代表甲状腺功能亢进症的门诊管理有所改善。然而,这种改善并未转化为医院环境中的治疗结果。