ArticleAnnals of intensive care2023
Critically ill severe hypothyroidism: a retrospective multicenter cohort study.
Article in Annals of intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 28 citations in OpenAlex.
- Disrupted thyroid hormone homeostasis in critical illness: clinical correlates and associations with hormone supplementation in a single-center retrospective observational study.Anaesthesiology intensive therapy · 2026Observational
- Myxedema Coma Despite Mild Biochemical Hypothyroidism: A Case of Profound Clinical Decompensation.Cureus · 2026Article
- Effects of immune checkpoint inhibitors on perioperative endocrine abnormalities and intraoperative hemodynamics in patients undergoing radical gastrectomy: a retrospective propensity score-matched cohort study.Journal of anesthesia · 2026Article
- From the Popoveniuc Score to Therapeutic Protocols: A Comprehensive Review of Myxedema Coma.Cureus · 2026Review
- Guidelines for the management of atrial fibrillation in adult patients admitted to an intensive care unit.Annals of intensive care · 2026Article
- A Case of Myxedema Coma in a 48-Year-Old Female Presenting With Altered Mental Status Post-trauma.Cureus · 2025Article
- A Rare Endocrinological Emergency in Children with Hypothyroidism: Clinical Evaluation of Cases Presenting with Myxedema Coma.Turkish archives of pediatrics · 2025Article
- Interaction Between Cardiogenic Shock and Hypothyroidism in Critical Care Medicine.JACC. Case reports · 2025Article
- Delayed Diagnosis of Myxedema Coma in a Patient With Concurrent Severe Intracranial Atherosclerotic Disease.Cureus · 2025Article
- Myxoedema coma and myxoedema heart disease.European heart journal · 2025Article
- Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series.Internal and emergency medicine · 2024Article
- Profound postinduction hypotension precipitated by immune checkpoint inhibitors: a case report.Journal of medical case reports · 2024Article
- Association of sensitivity to thyroid hormones with all-cause mortality in euthyroid US adults: A nationwide cohort study.European thyroid journal · 2024Article
- Myxedema Coma as a Presentation of Panhypopituitarism Secondary to Traumatic Brain Injury.Case reports in endocrinology · 2024Article
- Myxedema Coma: A Grave Phenomenon Partially Reversed CKD Status With Treatment of Hypothyroidism.Cureus · 2023Article
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Authors and funding
35 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevere hypothyroidism (SH) is a rare but life-threatening endocrine emergency. Only a few data are available on its management and outcomes of the most severe forms requiring ICU admission. We aimed to describe the clinical manifestations, management, and in-ICU and 6-month survival rates of these patients.
methodsWe conducted a retrospective, multicenter study over 18 years in 32 French ICUs. The local medical records of patients from each participating ICU were screened using the International Classification of Disease 10th revision. Inclusion criteria were the presence of biological hypothyroidism associated with at least one cardinal sign among alteration of consciousness, hypothermia and circulatory failure, and at least one SH-related organ failure.
resultsEighty-two patients were included in the study. Thyroiditis and thyroidectomy represented the main SH etiologies (29% and 19%, respectively), while hypothyroidism was unknown in 44 patients (54%) before ICU admission. The most frequent SH triggers were levothyroxine discontinuation (28%), sepsis (15%), and amiodarone-related hypothyroidism (11%). Clinical presentations included hypothermia (66%), hemodynamic failure (57%), and coma (52%). In-ICU and 6-month mortality rates were 26% and 39%, respectively. Multivariable analyses retained age > 70 years [odds ratio OR 6.01 (1.75-24.1)] Sequential Organ-Failure Assessment score cardiovascular component ≥ 2 [OR 11.1 (2.47-84.2)] and ventilation component ≥ 2 [OR 4.52 (1.27-18.6)] as being independently associated with in-ICU mortality.
conclusionsSH is a rare life-threatening emergency with various clinical presentations. Hemodynamic and respiratory failures are strongly associated with worse outcomes. The very high mortality prompts early diagnosis and rapid levothyroxine administration with close cardiac and hemodynamic monitoring.
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