Crit Care: Effects of early glucocorticoid therapy in patients with thyroid storms.

Thyroid storms are a life-threatening disease with a mortality rate of more than 10%.
Although glucocorticoids have been recommended as a treatment for thyroid storms, there is a lack of evidence based on large-scale clinical studies.
, a study published in Critical Care, the leading journal of critical care, was designed to assess the role of glucocorticoids in the treatment of patients with severe thyroid storms.
researchers conducted a retrospective national cohort study using Japan's national administrative claims database.
the study included patients admitted to intensive care units from 2013 to 2017 due to severe thyroid storms.
the main outcome of the study was in-hospital mortality, with a secondary outcome of mortality within 30 days and insulin therapy during hospitalization.
In addition to prtrend score matching (PSM), the researchers used the Broad linear hybrid model (GLMM) of Bayesian estimations with the largest likely estimation (MLE) and the Markov chain Monte Carlo method (MCMC).
the study included 811 patients, of whom 600 received glucocorticoid therapy and 211 did not receive glucocorticoid therapy.
early giving glucocorticoids was not related to significant improvements in hospital mortality in thyroid storm patients (GLMM (MLE), GLMM (MCMC) and PSM with a correction ratio of 1.77 (0.95-3.34), 1.44 (1.14-1.93) and 1.46 (0.72-3.00), respectively. The mortality rate results for 30 days in
were almost the same as those in hospital.
, however, insulin use was significantly higher in the glucocorticoid group.
, the results of the study show that the use of glucocorticoids did not improve the survival rate of thyroid storm patients.
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