A retrospective study of Graves' disease patients in North Texas: An epidemiological study

Graves' disease is an autoimmune thyroid disorder (AITD) that is eight to ten times more prevalent among Caucasian women in between the second and fifth decade of life. The purpose of this retrospective epidemiological study was three-fold: (a) to characterize Graves' disease by the descriptive covariates of gender, age, race, ethnicity, county of residence, number of autoimmune diagnoses, length of hospital stay, cost of hospitalization, and payor source; (b) to determine the most common diagnoses (comorbidities), including other autoimmune diseases; and (c) to determine if age, gender, race, ethnicity, or county of residence are significant predictors of cost of hospitalization, length of hospitalization, payor source, or number of autoimmune diagnoses. The purposive sample was collected from the Dallas-Fort Worth Metropolitan Statistical Area and was comprised of 2,068 individuals hospitalized with Graves' disease (ICD-9-CM code of 242.0) during the period of 1999–2005. The secondary data set was part of a larger sample of 65,536 patients hospitalized with at least one of 21 autoimmune diseases during the seven year time period. Primary statistical tests included stepwise linear regressions and a series of logistic regressions.

The ratio of female to male patients with Graves' disease was 5:1. A significant finding was the higher prevalence of cardiac arrhythmias among Graves' disease patients, with atrial fibrillation being the most frequent principal diagnosis (other than Graves'). Male patients were more likely to have no health insurance and higher cost of hospitalization, while female patients were nearly three times more likely to be on Medicaid. Non-Caucasian patients were more likely to have longer lengths of stay and have either Medicaid or self pay as payor source. Hispanic patients were nearly three times more likely to have no insurance and nearly two times more likely to be on Medicaid.

Healthy People objectives challenge health educators and health care providers to eliminate health disparities related to gender, income, ethnicity, race, and age. This study highlighted differences based on descriptive covariates, as well as an increased prevalence of cardiovascular conditions for patients with Graves' disease. Numerous determinants factor into a patient's prognosis, and as such, patient education should be a crucial component of the multidisciplinary effort to assist those with Graves' disease.