Navigating Thyroid Crises: A Nationwide Analysis of the Weekend Effect and Mortality Trends in Myxedema Coma (2016-2020)

Our objective was to utilize the National Inpatient Sample (NIS) database for analyzing the outcomes of myxedema coma based on the day of admission and explore five-year mortality trends. This retrospective cohort study examined in-patient mortality and secondary outcomes of patients with myxedema coma from 2016 to 2020 using the NIS database. Patients were selected using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes and divided into weekday and weekend admission groups. From 174,776,205 discharges, 5095 patients were included. Mean age of admitted patients was higher on weekdays (67.1 year) than weekends (66.5), with females constituting 69.4% and 67.4% of admissions, respectively. Weekend admissions had higher odds of inpatient mortality compared to weekdays [adjusted odds ratio (aOR): 1.9, p = 0.01]. The overall mortality rate for myxedema coma rose from 6.8% in 2016 to 13.4% in 2020 (p-value = 0.01). No significant difference in the length of stay, hospitalization cost, and charges, blood transfusion, acute kidney injury requiring dialysis, acute respiratory failure requiring intubation and parenteral nutrition was noted between weekday and weekend admissions. Further studies are needed to identify factors contributing to this disparity and to confirm the findings of increasing mortality related to myxedema.