THYROID TROUBLE AND THE HEART: A NATIONAL ANALYSIS OF HYPOTHYROIDISM'S IMPACT IN CARDIOGENIC SHOCK

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ASCVD/CVD Risk Assessment Hypothyroidism can impact multiple organ systems, including the cardiovascular system. Cardiogenic shock, a severe condition with high mortality, may be influenced by hypothyroidism. This study examines the effect of hypothyroidism on in-hospital mortality in cardiogenic shock patients using the National Inpatient Sample (NIS) database. A retrospective analysis of the NIS database (2016-2019) identified patients with hypothyroidism (ICD-10-CM code E03) and cardiogenic shock (ICD-10-CM code R57.0), excluding those with septic shock. The primary outcome was in-hospital mortality, with secondary outcomes including hospitalization costs, length of stay, comorbidities, and complications. Multivariable logistic regression was used to assess mortality, adjusting for demographics, comorbidities, and disease severity. Out of 130,145 adults with cardiogenic shock, 12.32% (16,045 patients) had hypothyroidism. The mean age was 66.5 years ± 14.31, with 62.39% male and 68.18% Caucasian. The overall in-hospital mortality was 33.5% (43681 patients), slightly higher among patients without Hypothyroidism 33.67% vs 32.98% for those with hypothyroidism, p = 0.0821. Patients with hypothyroidism had a lower average hospitalization cost ($201,621 vs. $240,906, p <0.0001) and shorter lengths of stay (10.1 days vs. 11.2 days, p <0.0001). Multiple logistic regression analysis revealed that Hypothyroidism was not a significant predictor of mortality (OR 0.95, 95% CI 0.91 - 0.99, p = 0.014) but cardiac arrest (OR 2.96, 95% CI 2.84 - 3.08, p < 0.0001) and respiratory failure was a significant predictor (OR 2.93, 95% CI 2.84 - 3.01, p < 0.0001). Hypothyroid patients with cardiogenic shock had higher rates of coronary artery disease, peripheral artery disease, atrial fibrillation, type 2 diabetes, obesity, and obstructive sleep apnea, but lower rates of acute coronary syndrome, ventricular arrhythmias, and stroke. No significant differences in hypertension or acute kidney injury were found. Table 1. In conclusion, hypothyroidism in cardiogenic shock patients does not significantly affect in-hospital mortality but is associated with lower costs and shorter stays. The higher comorbidity prevalence highlights the need for personalized management and early complication prevention. Further research is needed to clarify the link between hypothyroidism and cardiovascular outcomes for better preventive strategies.

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