Assessing the Quality of Care of Pregnant Patients With Thyrotoxicosis at an Urban Safety Net Hospital
Authors' conclusion
The QoC of thyrotoxicosis in pregnancy at this tertiary care center can be improved. A larger study is needed to assess the potential impacts of race and SES on the care of pregnant patients with thyrotoxicosis.
Study context
- Population
- Pregnant patients with thyrotoxicosis or a history of Graves disease who delivered in 2015–2021; mean age 31.5 years, 76% Black, 86% non-Hispanic
- Participants
- 147 patients
- Outcome
- Quality of care (QoC), assessed by thyroid hormone and thyroid stimulating immunoglobulin (TSI) levels, fetal US and endocrine referrals, based on current guidelines
Methodological detailssingle-centre, tertiary care safety net hospital, guideline-based assessment
- Single-centre
- Tertiary care safety net hospital
- Guideline-based assessment
Recommendations
As reported in the abstract
QoC measures by group
| Outcome | Low TSH | Active GD | Past GD |
|---|---|---|---|
| Repeat TSH measured | 75% | — not stated in the abstract | — not stated in the abstract |
| TSI measured | 33% | — not stated in the abstract | 56% |
| Free thyroxine at goal | — not stated in the abstract | 35% | — not stated in the abstract |
| Endocrine care or referral | — not stated in the abstract | 90% | — not stated in the abstract |
| First-trimester TSH measured | — not stated in the abstract | — not stated in the abstract | 78% |
| TSH at goal | — not stated in the abstract | — not stated in the abstract | 58% |
— not stated in the abstract
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| TSI and repeat TSH measured, by ethnicityHispanic vs Non-Hispanic · more likely in Hispanic | TSI measured 58% vs 29% | P = 0.04 |
| TSI and repeat TSH measured, by ethnicityHispanic vs Non-Hispanic · more likely in Hispanic | Repeat TSH measured 100% vs 71% | P = 0.03 |
| First-trimester TSH checked, by raceBlack vs Other races · less likely in Black patients | TSH checked in first trimester 85% vs 100% | P = 0.048 |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Assessing the Quality of Care of Pregnant Patients With Thyrotoxicosis at an Urban Safety Net Hospital. Endocr Pract. Published 12 October 2024. doi:10.
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