Malak Al Qubaisi1, Philip I Haigh2. 1. Royal College of Surgeons in Ireland, Dublin, Ireland. 2. Department of Surgery, Kaiser Permanente Los Angeles Medical Center, CA.
Abstract
CONTEXT: Total thyroidectomy has been shown to provide a cost-effective and efficient method of permanently treating Graves disease; however, hypocalcemia can be a common complication. OBJECTIVE: To evaluate the risk of hypocalcemia after total thyroidectomy in patients with vs without Graves disease. DESIGN: The 2016 American College of Surgeons National Surgical Quality Improvement Program participant use data files for procedure-targeted thyroidectomy and from 5871 patients were merged. This study included any patient who underwent total thyroidectomy. MAIN OUTCOME MEASURES: Whether symptomatic hypocalcemia developed anytime within 30 days after the thyroidectomy. A clinically severe hypocalcemic event was also evaluated as a secondary outcome measure. RESULTS: Of the 2143 patients who underwent total thyroidectomy, 222 patients experienced hypocalcemia after surgery, 124 of whom had symptomatic hypocalcemia postoperatively. Among patients with hypocalcemia, 16.3% had Graves disease, whereas only 9.4% of patients without Graves disease experienced significant hypocalcemia. Multivariable logistic regression analysis revealed that women (odds ratio = 1.79; 95% confidence interval = 1.16-2.76; p = 0.009) and patients who underwent parathyroid autotransplantation (odds ratio = 1.91; 95% confidence interval = 1.30-2.81; p = 0.001) were at greater risk of development of hypocalcemia. Older patients were less likely to experience hypocalcemia postoperatively (odds ratio = 0.586; 95% confidence interval = 0.44-0.79; p = 0.0001). CONCLUSION: Patients with Graves disease are about twice as likely to experience hypocalcemia or clinically severe hypocalcemia postoperatively than are patients without the disease.
CONTEXT: Total thyroidectomy has been shown to provide a cost-effective and efficient method of permanently treating Graves disease; however, hypocalcemia can be a common complication. OBJECTIVE: To evaluate the risk of hypocalcemia after total thyroidectomy in patients with vs without Graves disease. DESIGN: The 2016 American College of Surgeons National Surgical Quality Improvement Program participant use data files for procedure-targeted thyroidectomy and from 5871 patients were merged. This study included any patient who underwent total thyroidectomy. MAIN OUTCOME MEASURES: Whether symptomatic hypocalcemia developed anytime within 30 days after the thyroidectomy. A clinically severe hypocalcemic event was also evaluated as a secondary outcome measure. RESULTS: Of the 2143 patients who underwent total thyroidectomy, 222 patients experienced hypocalcemia after surgery, 124 of whom had symptomatic hypocalcemia postoperatively. Among patients with hypocalcemia, 16.3% had Graves disease, whereas only 9.4% of patients without Graves disease experienced significant hypocalcemia. Multivariable logistic regression analysis revealed that women (odds ratio = 1.79; 95% confidence interval = 1.16-2.76; p = 0.009) and patients who underwent parathyroid autotransplantation (odds ratio = 1.91; 95% confidence interval = 1.30-2.81; p = 0.001) were at greater risk of development of hypocalcemia. Older patients were less likely to experience hypocalcemia postoperatively (odds ratio = 0.586; 95% confidence interval = 0.44-0.79; p = 0.0001). CONCLUSION:Patients with Graves disease are about twice as likely to experience hypocalcemia or clinically severe hypocalcemia postoperatively than are patients without the disease.
Authors: Noah B Sands; Richard J Payne; Valerie Côté; Michael P Hier; Martin J Black; Michael Tamilia Journal: Otolaryngol Head Neck Surg Date: 2011-07-12 Impact factor: 3.497
Authors: H Yamashita; T Murakami; S Noguchi; M Shiiba; S Watanabe; S Uchino; H Kawamoto; M Toda; N Murakami Journal: Ann Surg Date: 1999-02 Impact factor: 12.969
Authors: Eun Ho Eunice Choi; Fares Qeadan; Eyas Alkhalili; Christina Lovato; Mark R Burge Journal: J Investig Med Date: 2021-03-31 Impact factor: 2.895
Authors: Elisabeth Maurer; Christian Vorländer; Andreas Zielke; Cornelia Dotzenrath; Moritz von Frankenberg; Hinrich Köhler; Kerstin Lorenz; Theresia Weber; Joachim Jähne; Antonia Hammer; Knut A Böttcher; Katharina Schwarz; Carsten Klinger; Heinz J Buhr; Detlef K Bartsch Journal: J Clin Med Date: 2020-12-11 Impact factor: 4.241