Clinical Features and Outcomes of Myxedema Coma in Patients Hospitalized for Hypothyroidism: Analysis of the United States National Inpatient Sample
Abstract
Background: Hypothyroidism is a common endocrine condition and chronic thyroid hormone deficiency is associated with adverse effects across multiple organ systems. In compensated hypothyroidism, however, patients remain clinically stable due to gradual physiological adaptation. In contrast, the clinical syndrome of decompensated hypothyroidism referred to as myxedema coma (MC) is an endocrine emergency with high risk of mortality. Because of its rarity, there are currently limited data regarding MC. This study analyzes the clinical features and hospital outcomes of MC compared with hypothyroid patients without MC (nonMChypo) in national United States hospital data. Methods: A retrospective analysis of the National Inpatient Sample, a public database of inpatient admissions to nonfederal hospitals in the United States, 2016-2018, including adult patients with primary diagnosis of MC ( International Classification of Diseases 10th Revision [ICD-10]: E03.5) or nonMChypo (E03.0-E03.9, E89.0). Patient demographics, relevant clinical features, mortality, length of stay (LOS), and hospital costs were compared. Results: Of 18,635 patients hospitalized for hypothyroidism, 2495 (13.4%) had a diagnosis of MC. Sex distribution and race/ethnicity were similar between patients with MC and nonMChypo, whereas MC was associated with older patient age ( p = 0.02), public insurance ( p = 0.01), and unhoused status ( p = 0.04). More admissions with MC occurred in winter compared with other seaso…
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A recent mendelian randomization study supports a causal association between hypothyroidism and decreased sex hormone-binding globulin and testosterone levels.
“Arecentmendelianrandomizationstudysupportsacausalassociation between hypothyroidism and decreased sex hormonebinding globulin and testosterone levels. 50”
From Hypothyroidism: A Review (2025) · cites this paper as [50]
Cites
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Wartofsky, L. (2006) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2006.09.003 · Cited by 158 · see citing works
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Chaker, L., & Papaleontiou, M. (2025) · JAMA · doi:10.1001/jama.2025.13559 · Cited by 63 · see citing works
- Authors
- Chen, D. H., Hurtado, C. R., Chang, P., Zakher, M., & Angell, T. E.
- Affiliations
- University of Southern California (US)
- Division of Endocrinology, Diabetes and Metabolism, Los Angeles General Medicine Center, Los Angeles, California, USA.
- Corresponding author
- Angell, Trevor E.
- Venue
- Thyroid®
- Publisher
- SAGE Publications
- Published
- 2024-02-28
- Volume
- 34
- Issue
- 4
- Pages
- 419-428
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W4391278242
- Cited by
- 17
- References
- 2
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 6
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- myxedema coma, hypothyroidism, in-hospital mortality, length of hospital stay, hospital costs, endocrine emergencies, hospitalized patients, seasonal variation, homelessness, public insurance, clinical features, hospitalization outcomes, mortality risk factors
- MeSH terms
- Adult, Coma, Humans, Hypothyroidism, Inpatients, Length of Stay, Myxedema, Retrospective Studies, United States
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