{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:54:55Z","timestamp":1792612495163,"version":"4.5.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Overt hyperthyroidism has been associated with cardiac arrhythmias, hypercoagulopathy, stroke, and pulmonary embolism, all of which may increase mortality. Some, but not all, studies show an increased mortality in patients with hyperthyroidism. This inconsistency may be due to differences in study design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Based on an electronic PubMed search, using the Medical Subject Heading words such as hyperthyroidism, thyrotoxicosis, and mortality or survival, case\u2013control and cohort studies were selected and reviewed. Using meta-analysis, an overall relative risk (RR) of mortality was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight studies fulfilled the inclusion criteria, six of which showed an increased all-cause mortality; seven studies, including 31\u200a138 patients and 4\u200a00\u200a000 person years at risk, allowed calculation of mortality in a meta-analysis. Based on this, the RR of overall mortality was 1.21 (95% confidence interval: 1.05\u20131.38). Analyses including studies considering setting, treatment, and control for co-morbidity did not significantly alter this finding. As the measured heterogeneity (I<jats:sup>2<\/jats:sup>) ranges from 89.1 to 98.3%, which is much higher than the 50% generally viewed on as a threshold, the statistical heterogeneity is very pronounced in the included studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients diagnosed with hyperthyroidism, mortality is increased by \u223c20%. Future studies need to address the cause of hyperthyroidism, impact of type of therapy, time dependency, as well as the potential influence of confounding or genetic susceptibility before the question of causality can be answered.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-11-0299","type":"journal-article","created":{"date-parts":[[2011,7,4]],"date-time":"2011-07-04T07:59:24Z","timestamp":1309766364000},"page":"491-497","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":146,"title":["A critical review and meta-analysis of the association between overt hyperthyroidism and mortality"],"prefix":"10.1093","volume":"165","author":[{"given":"Frans","family":"Brandt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laszlo","family":"Heged\u00fcs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas H","family":"Brix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"issue":"1","key":"1_16723603","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/S0889-8529(05)70240-1","volume":"26","author":"Wang","year":"1997","journal-title":"Endocrinology and metabolism clinics of North America","ISSN":"https:\/\/id.crossref.org\/issn\/0889-8529","issn-type":"print"},{"issue":"10","key":"2_22390204","doi-asserted-by":"publisher","first-page":"3830","DOI":"10.1210\/jc.2006-0652","volume":"91","year":"2006","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"15","key":"3_29545154","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1161\/CIRCULATIONAHA.106.678326","volume":"116","author":"Klein","year":"2007","journal-title":"Circulation","ISSN":"https:\/\/id.crossref.org\/issn\/0009-7322","issn-type":"print"},{"issue":"5","key":"4_37019760","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1161\/STROKEAHA.109.577742","volume":"41","year":"2010","journal-title":"Stroke","ISSN":"https:\/\/id.crossref.org\/issn\/0039-2499","issn-type":"print"},{"key":"5_40809632","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1111\/j.1538-7836.2010.03993.x","volume":"8","year":"2010","journal-title":"JOURNAL OF THROMBOSIS AND HAEMOSTASIS"},{"key":"6_40809633","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s12020-009-9271-2","volume":"36","year":"2009","ISSN":"https:\/\/id.crossref.org\/issn\/1355-008X","issn-type":"print"},{"issue":"7","key":"7_28497606","doi-asserted-by":"publisher","first-page":"2421","DOI":"10.1210\/jc.2007-0179","volume":"92","year":"2007","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"11","key":"8_10968406","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1001\/jama.282.11.1054","volume":"282","author":"Juni","year":"1999","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"issue":"3","key":"9_14034397","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Controlled clinical trials","ISSN":"https:\/\/id.crossref.org\/issn\/0197-2456","issn-type":"print"},{"key":"10_36521673","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1258\/1355819021927674","volume":"7","year":"2002","journal-title":"JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY"},{"issue":"7122","key":"11_5861011","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1136\/bmj.315.7122.1610","volume":"315","author":"Smith","year":"1997","journal-title":"BMJ","ISSN":"https:\/\/id.crossref.org\/issn\/0959-8138","issn-type":"print"},{"key":"12_31765352","first-page":"133","volume":"33","year":"2001","journal-title":"JOURNAL OF INSURANCE MEDICINE"},{"key":"13_31765355","first-page":"14","volume":"38","year":"2006","journal-title":"JOURNAL OF INSURANCE MEDICINE"},{"key":"14_40809634","first-page":"2283","volume":"50","year":"1999","journal-title":"Cancer Research","ISSN":"https:\/\/id.crossref.org\/issn\/0008-5472","issn-type":"print"},{"issue":"3","key":"15_10216232","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1530\/acta.0.1280230","volume":"128","author":"Hall","year":"1993","journal-title":"European Journal of Endocrinology","ISSN":"https:\/\/id.crossref.org\/issn\/0804-4643","issn-type":"print"},{"issue":"6","key":"16_9781723","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1002\/ijc.2910500611","volume":"50","author":"Hall","year":"1992","journal-title":"International journal of cancer. Journal international du cancer","ISSN":"https:\/\/id.crossref.org\/issn\/0020-7136","issn-type":"print"},{"issue":"4","key":"17_6097468","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1001\/jama.280.4.347","volume":"280","author":"Ron","year":"1998","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"issue":"11","key":"18_5904156","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1056\/NEJM199803123381103","volume":"338","author":"Franklyn","year":"1998","journal-title":"New England Journal of Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"issue":"9170","key":"19_10865541","doi-asserted-by":"publisher","first-page":"2111","DOI":"10.1016\/S0140-6736(98)12295-X","volume":"353","author":"Franklyn","year":"1999","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0140-6736","issn-type":"print"},{"issue":"1","key":"20_19248224","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1001\/jama.294.1.71","volume":"294","author":"Franklyn","year":"2005","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"issue":"9285","key":"21_11330729","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/S0140-6736(01)06067-6","volume":"358","author":"Parle","year":"2001","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0140-6736","issn-type":"print"},{"issue":"6","key":"22_17183775","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1089\/105072502760143854","volume":"12","author":"Osman","year":"2002","journal-title":"Thyroid : official journal of the American Thyroid Association","ISSN":"https:\/\/id.crossref.org\/issn\/1050-7256","issn-type":"print"},{"issue":"21","key":"23_18546874","doi-asserted-by":"publisher","first-page":"2591","DOI":"10.1001\/jama.292.21.2591","volume":"292","author":"Gussekloo","year":"2004","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"issue":"7","key":"24_19296250","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1089\/thy.2005.15.718","volume":"15","author":"Nyirenda","year":"2005","journal-title":"Thyroid : official journal of the American Thyroid Association","ISSN":"https:\/\/id.crossref.org\/issn\/1050-7256","issn-type":"print"},{"issue":"9","key":"25_21651377","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1001\/jama.295.9.1033","volume":"295","author":"Cappola","year":"2006","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"issue":"6","key":"26_21747716","doi-asserted-by":"publisher","first-page":"2159","DOI":"10.1210\/jc.2005-1833","volume":"91","year":"2006","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"1","key":"27_23102118","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jacc.2006.08.042","volume":"49","year":"2007","journal-title":"Journal of the American College of Cardiology","ISSN":"https:\/\/id.crossref.org\/issn\/0735-1097","issn-type":"print"},{"issue":"4","key":"28_28270347","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.amjmed.2006.04.034","volume":"120","author":"Bauer","year":"2007","journal-title":"The American journal of medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9343","issn-type":"print"},{"issue":"6","key":"29_27945641","doi-asserted-by":"publisher","first-page":"2190","DOI":"10.1210\/jc.2006-2321","volume":"92","year":"2007","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"2","key":"30_8594571","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1093\/oxfordjournals.aje.a113296","volume":"115","author":"HOFFMAN","year":"1982","journal-title":"American Journal of Epidemiology","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9262","issn-type":"print"},{"key":"31_12146138","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1177\/003591576505800503","volume":"58","author":"Hill","year":"1965","journal-title":"Proceedings of the Royal Society of Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0035-9157","issn-type":"print"},{"issue":"2","key":"32_18668432","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1210\/jc.2004-1554","volume":"90","year":"2005","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"4","key":"33_5424782","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/S0733-8627(20)30322-9","volume":"7","author":"Roth","year":"1989","journal-title":"Emergency medicine clinics of North America","ISSN":"https:\/\/id.crossref.org\/issn\/0733-8627","issn-type":"print"},{"issue":"11","key":"34_31113972","doi-asserted-by":"crossref","first-page":"832","DOI":"10.7326\/0003-4819-148-11-200806030-00225","volume":"148","year":"2008","journal-title":"Annals of Internal Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/0003-4819","issn-type":"print"},{"issue":"3","key":"35_5922942","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1210\/jc.83.3.765","volume":"83","author":"Laurberg","year":"1998","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"2","key":"36_11039553","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1210\/jc.86.2.930","volume":"86","author":"Brix","year":"2001","journal-title":"Journal of Clinical Endocrinology &amp; Metabolism","ISSN":"https:\/\/id.crossref.org\/issn\/0021-972X","issn-type":"print"},{"issue":"1","key":"37_18073073","first-page":"2","volume":"14","author":"Ilias","year":"2004","journal-title":"Ethnicity &amp; disease","ISSN":"https:\/\/id.crossref.org\/issn\/1049-510X","issn-type":"print"},{"key":"38_40809635","first-page":"319","volume":"97","year":"2006","journal-title":"Human genetics","ISSN":"https:\/\/id.crossref.org\/issn\/0340-6717","issn-type":"print"},{"key":"39_39729880","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1375\/13690520460741471","volume":"7","year":"2004","journal-title":"TWIN RESEARCH"},{"issue":"4","key":"40_5825031","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1038\/ng1297-387","volume":"17","author":"Martin","year":"1997","journal-title":"Nature genetics","ISSN":"https:\/\/id.crossref.org\/issn\/1061-4036","issn-type":"print"},{"issue":"7414","key":"41_17798867","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ","ISSN":"https:\/\/id.crossref.org\/issn\/0959-8138","issn-type":"print"}],"container-title":["European Journal of Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/165\/4\/491.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/eje.bioscientifica.com\/view\/journals\/eje\/165\/4\/491.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:26:46Z","timestamp":1676392006000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejendo\/article\/165\/4\/491\/6676905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10]]},"references-count":41,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.1530\/eje-11-0299","relation":{},"ISSN":["0804-4643","1479-683X"],"issn-type":[{"value":"0804-4643","type":"print"},{"value":"1479-683X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10]]}}}