(19) Estimating Incidence and Case Fatality of Thyroid Storm in Germany Between 2007 and 2017: A Claims Data Analysis

Publication Number: 350

Background: To date, only three studies have reported on the epidemiology of thyroid storm using population-based databases (Japan, Taiwan, and the United States) and data on its fatality are also limited.

Objectives: Given the general lack of descriptive epidemiological studies on thyroid storm, we aimed to estimate the incidence rate and case fatality of thyroid storm in Germany based on a large claims database.

Methods: Using the German Pharmacoepidemiological Research Database (GePaRD) we identified patients with at least one inpatient discharge diagnosis of thyroid storm (International Statistical Classification of Diseases and Related Health Problems, 10th revision, German modification; ICD-10-GM E05.5) between 2007 and 2017 and calculated age-standardized and age-specific incidence rates in males and females. We defined deaths occurring within 30 days of the diagnosis as thyroid storm-associated and determined case fatality by sex and age group.

Results: Overall, we identified 1,690 patients with an incident diagnosis of thyroid storm (72% females). Mean age was 60 years (standard deviation: 18.6 years). The age-standardized incidence rate per 100,000 persons per year was 1.4 (95% confidence interval [CI] 1.2 to 1.7) in females and 0.7 (95% CI 0.5 to 0.9) in males. In females ≤60 and >60 years of age, the incidence rate was 0.9 (males 0.4) and 2.7 (males 1.7), respectively. The case fatality of thyroid storm was 1.0% in males ≤60 years (females: 1.4%) and 16.7% in males >60 years of age (females: 10.9%).

Conclusions: Incidence rates of thyroid storm were markedly higher in females than in males and were three times higher in persons >60 years compared to younger age groups. Case fatality was below 2% in persons aged ≤60 years and markedly higher in older persons (males: 17 times, females: 8 times).