This study aimed to identify independent predictors of quality-of-life (QoL) impairment in Graves' hyperthyroidism (GH) outpatients and develop a clinically applicable nomogram. A total of 402 GH patients were recruited from an endocrinology clinic (January 2024–June 2025). Assessments included ThyPRO-39, PSQI, HAMD, and HAMA. Multivariate analysis identified thyroid eye disease, goiter, sleep disturbances, anxiety, and depression as independent predictors. The nomogram exhibited excellent discrimination, with AUC values of 0.886 (training) and 0.844 (validation). Bootstrap calibration confirmed strong consistency, and decision curve analysis demonstrated favorable net clinical benefit. An accompanying online dynamic calculator was developed to enhance clinical utility. The nomogram provides a reliable tool for early identification of high-risk patients in outpatient settings, though future external validation is warranted to confirm generalizability.

Doudou Li serves as a Chief Nurse at the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine. She earned her master's degree in Integrated Traditional Chinese and Western Medicine Nursing from Nanjing University of Chinese Medicine in 2016. With extensive endocrinology experience, she has led provincial research on ear scraping therapy for Graves' disease and lifestyle medicine shared appointments for diabetes remission. She has published in the Chinese Journal of Nursing, holds patents for medical devices like ear scraping apparatus and moxibustion instruments, and has organized provincial continuing education programs on integrated diabetes nursing.