BACKGROUND: As more patients undergo diagnostic thyroid surgery, the development of posthemithyroidectomy hypothyroidism is becoming a major concern. We hypothesized that the preoperative thyrotropin (thyroid-stimulating hormone, TSH) level and ultrasonographically measured thyroid volume, both commonly available in thyroid nodule patients, may predict the development of posthemithyroidectomy hypothyroidism. METHOD: Among the 132 patients who underwent hemithyroidectomy from January 2004 to January 2006, a total of 101 patients who were followed for more than a year were included in the analysis. RESULTS: Biochemical hypothyroidism developed in 37 patients (36.6%). Patients who developed postoperative hypothyroidism showed higher TSH levels (P < 0.001) and smaller remnant thyroid volumes (P = 0.014). Logistic regression analysis showed that the TSH level and remnant thyroid volume were independent predictors of posthemithyroidectomy hypothyroidism (P < 0.001 and P = 0.04, respectively). A risk scoring system using these two factors was created based on the results of logistic regression analyses. The incidences of hypothyroidism were 5.3%, 12.1%, 51.7%, and 85.0% according to the risk scores of 0, 1, 2, and 3, respectively. CONCLUSIONS: Patients with a high preoperative TSH level and small thyroid volume are at high risk of developing hypothyroidism following hemithyroidectomy. Potential risk of postoperative hypothyroidism should be discussed with these patients when thyroid surgery is being considered for a diagnostic purpose.
BACKGROUND: As more patients undergo diagnostic thyroid surgery, the development of posthemithyroidectomy hypothyroidism is becoming a major concern. We hypothesized that the preoperative thyrotropin (thyroid-stimulating hormone, TSH) level and ultrasonographically measured thyroid volume, both commonly available in thyroid nodule patients, may predict the development of posthemithyroidectomy hypothyroidism. METHOD: Among the 132 patients who underwent hemithyroidectomy from January 2004 to January 2006, a total of 101 patients who were followed for more than a year were included in the analysis. RESULTS: Biochemical hypothyroidism developed in 37 patients (36.6%). Patients who developed postoperative hypothyroidism showed higher TSH levels (P < 0.001) and smaller remnant thyroid volumes (P = 0.014). Logistic regression analysis showed that the TSH level and remnant thyroid volume were independent predictors of posthemithyroidectomy hypothyroidism (P < 0.001 and P = 0.04, respectively). A risk scoring system using these two factors was created based on the results of logistic regression analyses. The incidences of hypothyroidism were 5.3%, 12.1%, 51.7%, and 85.0% according to the risk scores of 0, 1, 2, and 3, respectively. CONCLUSIONS:Patients with a high preoperative TSH level and small thyroid volume are at high risk of developing hypothyroidism following hemithyroidectomy. Potential risk of postoperative hypothyroidism should be discussed with these patients when thyroid surgery is being considered for a diagnostic purpose.
Authors: David S Cooper; Gerard M Doherty; Bryan R Haugen; Richard T Kloos; Stephanie L Lee; Susan J Mandel; Ernest L Mazzaferri; Bryan McIver; Steven I Sherman; R Michael Tuttle Journal: Thyroid Date: 2006-02 Impact factor: 6.568
Authors: Hossein Gharib; Enrico Papini; Roberto Valcavi; H Jack Baskin; Anna Crescenzi; Massimo E Dottorini; Daniel S Duick; Rinaldo Guglielmi; Carlos Robert Hamilton; Martha A Zeiger; Michele Zini Journal: Endocr Pract Date: 2006 Jan-Feb Impact factor: 3.443
Authors: Jin Seong Cho; Sun Hyoung Shin; Young Ju Song; Hee Kyung Kim; Min Ho Park; Jung Han Yoon; Young Jong Jegal Journal: J Korean Surg Soc Date: 2011-11-25