Outpatient Endocrine Diagnosis and Treatment of Thyroid Diseases and Disorders in a Portuguese Public University Hospital

Abstract

Background: Thyroid diseases and disorders account for most of the activity of outpatient endocrine departments, but objective data regarding the care of such patients is difficult to find. Knowledge of that data would be fundamental for the planning of those departments and to develop translational research.

Methods: A specific database was defined using the Statistical Package for the Social Sciences Program (SPSS IBM, 24th version, 2017) to include the records of all patients assisted by one of us, between January 2005 and December 2016, at the outpatient endocrine department of a public university hospital. Clinical and analytical data regarding the first and last visits was included. Statistical analysis used the same software program.

Results: A total of 1,222 patients were included. Diagnostic groups were: 1) Simple nodular goiter (SNG) (46%); 2) Hashimotos thyroiditis (HT) (29%); 3) Graves disease (GD) (10%); 4) Toxic nodular goiter (TNG) (7%); and 5) Thyroid neoplasia (TN) (5%). After a mean follow-up of 5 years most patients with GD (70%), TNG (77%), HT (67%) and TN (92%) but no patients with SNG (32%) had either received definitive treatment or were being treated. However the euthyroid state was far from universal and not significantly different across groups (62-86%).

Conclusions: Continued specialist care of patients with thyroid diseases and disorders is far from perfect. It corrects thyroid dysfunction in most but not all patients and most patients remain on thyroid medications, despite definitive treatment in many. Long-term follow-up of these patients is probably the responsibility of the endocrine team. Otherwise major complications may come to the attention of the specialists only when late recognition is made by general physicians or internists.




J Endocrinol Metab. 2019;9(1-2):3-17
doi: https://doi.org/10.14740/jem550