Seung Taek Lim1, Ye Won Jeon1, Hongki Gwak1, Young Jin Suh2. 1. From the Division of Breast & Thyroid Surgical Oncology, Department of Surgery, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Gyeonggi-do, Republic of Korea. 2. From the Division of Breast & Thyroid Surgical Oncology, Department of Surgery, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Gyeonggi-do, Republic of Korea.. Electronic address: yjsuh@catholic.ac.kr.
Abstract
OBJECTIVE: This study aimed to investigate the incidence rates, risk factors, and clinical implications of delayed hypoparathyroidism on postoperative day 2 (POD-2) after total thyroidectomy in patients with papillary thyroid carcinoma. METHODS: This study included 410 patients with normal serum intact parathyroid hormone (iPTH) and calcium levels on postoperative day 1 (POD-1) who were classified into 2 groups according to the presence or absence of delayed hypoparathyroidism on POD-2. RESULTS: Of the 410 patients, 98 experienced delayed hypoparathyroidism on POD-2 (23.9%). The significant risk factors for delayed hypoparathyroidism on POD-2 included female gender, age older than 45 years, central lymph node dissection, increased number of excised lymph nodes, and low POD-1 versus preoperative iPTH ratios. Additionally, delayed hypoparathyroidism on POD-2 was found to be a significant risk factor for hypocalcemia on POD-2 and permanent hypoparathyroidism. CONCLUSION: Prophylactic calcium supplementation and long-term surveillance for permanent hypoparathyroidism should be considered in patients with risk factors for delayed hypoparathyroidism on POD-2. ABBREVIATIONS: CI = confidence interval; iPTH = intact parathyroid hormone; OR = odds ratio; POD-1 = postoperative day 1; POD-2 = postoperative day 2; PTC = papillary thyroid carcinoma; ROC = receiver operating characteristic.
OBJECTIVE: This study aimed to investigate the incidence rates, risk factors, and clinical implications of delayed hypoparathyroidism on postoperative day 2 (POD-2) after total thyroidectomy in patients with papillary thyroid carcinoma. METHODS: This study included 410 patients with normal serum intact parathyroid hormone (iPTH) and calcium levels on postoperative day 1 (POD-1) who were classified into 2 groups according to the presence or absence of delayed hypoparathyroidism on POD-2. RESULTS: Of the 410 patients, 98 experienced delayed hypoparathyroidism on POD-2 (23.9%). The significant risk factors for delayed hypoparathyroidism on POD-2 included female gender, age older than 45 years, central lymph node dissection, increased number of excised lymph nodes, and low POD-1 versus preoperative iPTH ratios. Additionally, delayed hypoparathyroidism on POD-2 was found to be a significant risk factor for hypocalcemia on POD-2 and permanent hypoparathyroidism. CONCLUSION: Prophylactic calcium supplementation and long-term surveillance for permanent hypoparathyroidism should be considered in patients with risk factors for delayed hypoparathyroidism on POD-2. ABBREVIATIONS: CI = confidence interval; iPTH = intact parathyroid hormone; OR = odds ratio; POD-1 = postoperative day 1; POD-2 = postoperative day 2; PTC = papillary thyroid carcinoma; ROC = receiver operating characteristic.
Authors: Jens Bollerslev; Lars Rejnmark; Alexandra Zahn; Ansgar Heck; N M Appelman-Dijkstra; Luis Cardoso; Fadil M Hannan; Filomena Cetani; Tanja Sikjær; Anna Maria Formenti; Sigridur Björnsdottir; Camilla Schalin-Jantti; Zhanna Belaya; Fraser Wilson Gibb; Bruno Lapauw; Karin Amrein; Corinna Wicke; Corinna Grasemann; Michael Krebs; Eeva M Ryhänen; Ozer Makay; Salvatore Minisola; Sebastien Gaujoux; Jean-Philippe Bertocchio; Zaki K Hassan-Smith; Agnès Linglart; Elizabeth M Winter; Martina Kollmann; Hans-Georg Zmierczak; Elena Tsourdi; Stefan Pilz; Heide Siggelkow; Neil J Gittoes; Claudio Marcocci; Peter Kamenicky Journal: Eur J Endocrinol Date: 2022-01-13 Impact factor: 6.664