| Backgrounds and objectives:Incidence, mortality rate and case fatality rate of thyroid disorders recently reported at home and abroad has been increasing. Despite this, the epidemiological materials of thyroid disorders, eg.thyroid dysfunction, remains unclear, especially when compared with other endocrine disorders. The aims of the study were:1) to calculate and analyse the variation of the case fatality rate and underlying causes of death of inpatients with thyroid dysfunction in PUMCH from January 1983 to December 2009; 2) to do a comparison about death causes based on age,sex and duration of thyroid dysfunction, etc; 3) to analyse morbidity rate of some important complications or combinations of died thyroid dysfunction inpatients and find some risk factors for the sake of early prevention, early diagnosis and early treatment to decrease the mortality rate associated with thyroid dysfunction.Subjects and Methods:We collected and analysed all of the materials of thyroid dysfunction inpatients who died during hospitalization in PUMCH from Jan 1983 to Dec 2009. Firstly,the amount and ID numbers of thyroid dysfunction inpatients were obtained through computer search system of our hospital. Secondly, the medical records were investigated and reviewed in details for serviceable information. Thirdly, the case fatality rate, causes of death and its constituent ratios,morbidity rate of some important complications or combinations of dead thyroid dysfunction inpatients were calculated and analysed. Data input and analysis were conducted using the tool Microsoft Office Excel 2007 and packages SPSS 13.0 under the supervision of statistics specialist. Results:There were totally 4506 admitted and 75 died thyroid dysfunction inpatients during the past 27 yrs. The case fatality rate was 1.66%,2.45% for male and 1.36% for female, respectively,and with significant difference(p<0.01). Malignant tumors were the first underlying causes of death(37.3%),and then the endocrine, nutritional and metabolic diseases(32.0%), respiratory diseases(12.0%), circulatory diseases (8.0%) and connective tissue diseases(6.7%) followed. Among the malignant tumors,the most common type were from hematological system accouting for 39.3%, and then the respiratory system 32.1% and the digestive system 17.9% in turn.And those with primary hypothyroidism from the beginning or after treatment for hyperthyroidism had a significantly higher proportion than those with consistent hyperthyroidism (p<0.01). Underlying causes from the complications of thyroid disfunction accounted 30.6% of the total all-causes death rate,the majority was the complications from hyperthyroidism, accounting for 26.7%, among which,thyroid crisis 10.7%, hyperthyroid heart disease 6.7% and hyperthyroid agranulocytopenia 6.7%, respectively.While complications from hypothyroidism accounts for only 4.0%, which is composed of hypothyroid heat diseas, hypothyroid myxedema and secondary pulmonary infection, with a proportion of 1.3%, respectively.Conclusion:The case fatality rate of thyroid dysfunction was not uncommon.The most common underlying death causes of patients with thyroid dysfunction is malignant tumors, especially those from hematological system.Complications from hyperthyroid accounted for a larger proportion than those from hypothyroid,while malignant tumors were more common in hypothyroid inpatients than in hyperthyroid ones. Thyroid dysfunction seemed associated with a higher risk of malignant tumors. Further and larger studies are essential to explore and obtain more confident evidence. |
