Mortality rates and clinical manifestations of severe hypothyroidism in the ICU: a French multicenter cohort study

Summary: This article presents the findings of a retrospective multicenter cohort study conducted over 18 years in 32 French ICUs to investigate severe hypothyroidism (SH) requiring ICU admission.

The study included 82 patients with SH, with thyroiditis and thyroidectomy being the primary causes, and levothyroxine discontinuation, sepsis, and amiodarone-related hypothyroidism being the most frequent triggers.

Patients with SH presented with various clinical symptoms, including hypothermia, hemodynamic failure, and coma, with in-ICU and 6-month mortality rates being 26% and 39%, respectively. The study also found that patients with hemodynamic and respiratory failure on admission to the ICU had a higher likelihood of mortality.

Levothyroxine replacement was provided to all patients, but the administration route and loading dose varied. The authors recommend early diagnosis, prompt levothyroxine administration, and close monitoring of cardiac and hemodynamic parameters for SH patients admitted to the ICU.

Article: Critically ill severe hypothyroidism: a retrospective multicenter cohort study – Annals of Intensive Care