Alberto José Guillén Martínez1, Clara Smilg Nicolás2, Javier Moraleda Deleito3, Sergio Guillén Martínez4, Francisco García-Purriños García5. 1. Servicio de Otorrinolaringología, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España. Electronic address: alberto_jos@hotmail.com. 2. Servicio de Medicina Interna, Hospital General Universitario Santa Lucía, Cartagena, Murcia, España. 3. Department of Otolaryngology, University Hospital Lewisham, Londres, Reino Unido. 4. Servicio de Medicina Interna, Complejo Hospitalario Universitario de Albacete, Albacete, España. 5. Grupo de Investigación en Cabeza y Cuello de la Universidad Católica de San Antonio (UCAM), Servicio de Otorrinolaringología, Hospital Los Arcos del Mar Menor, Pozo Aledo, Murcia, España.
Abstract
INTRODUCTION: Hungry bone syndrome (HBS) is a complication occurring after parathyroid surgery that can cause severe and prolonged hypocalcemia. The study objective was to know the risk factors for HBS after surgery for primary hyperparathyroidism and its relationship with serum calcium and parathyroid hormone levels. MATERIAL AND METHODS: A case-control, observational, analytical study was conducted in patients who had undergone surgery for primary hyperparathyroidism in the past 10 years (2007-2016). Changes over time in serum calcium and PTH levels and the general characteristics of patients were analyzed. RESULTS: The incidence rate of HBS in our series was 12.2%. HBS was found to be significantly associated to thyroid surgery during the surgical procedure itself (adjusted odds ratio [aOR]=17.241), to age older than 68 years (aOR=6.666), and to lesions greater than 1.7cm (aOR=7.165). A statistically significant relationship was seen between presence of HBS and corrected serum calcium levels higher than the mean the day after surgery and one week and 3 months later, and also with PTH levels higher than the mean before, during, and one day after surgery. CONCLUSION: In our series, independent risk factors for development of HBS included patient age, lesion size, and whether or not the procedure was accompanied by thyroid surgery, which requires closer monitoring of mineral metabolism during the perioperative period.
INTRODUCTION:Hungry bone syndrome (HBS) is a complication occurring after parathyroid surgery that can cause severe and prolonged hypocalcemia. The study objective was to know the risk factors for HBS after surgery for primary hyperparathyroidism and its relationship with serum calcium and parathyroid hormone levels. MATERIAL AND METHODS: A case-control, observational, analytical study was conducted in patients who had undergone surgery for primary hyperparathyroidism in the past 10 years (2007-2016). Changes over time in serum calcium and PTH levels and the general characteristics of patients were analyzed. RESULTS: The incidence rate of HBS in our series was 12.2%. HBS was found to be significantly associated to thyroid surgery during the surgical procedure itself (adjusted odds ratio [aOR]=17.241), to age older than 68 years (aOR=6.666), and to lesions greater than 1.7cm (aOR=7.165). A statistically significant relationship was seen between presence of HBS and corrected serum calcium levels higher than the mean the day after surgery and one week and 3 months later, and also with PTH levels higher than the mean before, during, and one day after surgery. CONCLUSION: In our series, independent risk factors for development of HBS included patient age, lesion size, and whether or not the procedure was accompanied by thyroid surgery, which requires closer monitoring of mineral metabolism during the perioperative period.
Authors: Manju Chandran; John P Bilezikian; Nurshazwani Mat Salleh; Hao Ying; Joel Lau; James Lee; Mechteld C deJong; Aye Chan Maung; Rajeev Parameswaran Journal: Osteoporos Sarcopenia Date: 2022-03-24