Risk factors for the development of hypocalcemia in pediatric patients after total thyroidectomy - A systematic review.

Autor: Kao KT; Department of Endocrinology and Diabetes, The Royal Children's Hospital Melbourne, 50 Flemington Road, Parkville, VIC, 3052, Australia; Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia; Department of Paediatrics, University of Melbourne, 50 Flemington Road, Parkville, VIC, 3052, Australia. Electronic address: jeff.kao@rch.org.au., Ferguson EC; Murdoch Childrens Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia; Department of Endocrinology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield S10 2TH, UK., Blair G; Divisions of Pediatric Surgery, British Columbia Children's Hospital, 4500 Oak St, Vancouver, BC V6H 3N1, Canada; University of British Columbia, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada., Chadha NK; University of British Columbia, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada; Pediatric Otolaryngology-Head and Neck Surgery, British Columbia Children's Hospital, 4500 Oak St, Vancouver, BC V6H 3N1, Canada., Chanoine JP; University of British Columbia, 4480 Oak Street, Vancouver, BC V6H 3V4, Canada; Endocrinology and Diabetes Unit, British Columbia Children's Hospital, 4500 Oak St, Vancouver, BC V6H 3N1, Canada.
Jazyk: angličtina
Zdroj: International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2021 Apr; Vol. 143, pp. 110666. Date of Electronic Publication: 2021 Mar 04.
DOI: 10.1016/j.ijporl.2021.110666
Abstrakt: Objectives: Post-thyroidectomy hypocalcemia is a common complication that causes increased morbidity. This review aims to identify the factors that predict occurrence of hypocalcemia after total thyroidectomy in children and adolescents.
Methods: Comprehensive searches of English language pediatric (≤18 years of age) articles were performed in Medline, CINAHL, EMBASE, Web of Science and the Cochrane Library. Studies published between January 1, 1970 to August 20, 2020 regarding risk factors and strategies to prevent hypocalcemia were included if the study: 1. included only pediatric patients who were ≤18 years of age, 2. included only patients who had total, subtotal or completion thyroidectomy, 3. defined hypocalcemia as serum total calcium of <2.0 mmol/L (8 mg/dL) or ionized calcium of <1.0 mmol/L. The quality of included papers was assessed using the Newcastle-Ottawa scale. Results of all included studies were summarised. Meta-analyses were performed if appropriate.
Results: Five studies with a total of 477 patients between 0 and 18 years, who had total/subtotal/completion thyroidectomy, were included. Overall rates of transient hypocalcemia were higher than permanent hypocalcemia (transient n = 104, 22%; permanent n = 48, 10%). Two studies found intraoperative parathyroid hormone (PTH) useful in predicting hypocalcemia. While two single institution cohort studies reported that neck dissection, male sex and a lower Parathyroid Gland Remaining In Situ score were associated with hypocalcemia, two other studies, including one population-based cohort study, reported that age at surgery, patient sex, hospital volume, type of thyroid disease, number of identified parathyroid glands, parathyroid auto-transplantation, operation time, thyroid specimen weight, and lymph node dissection were not risk factors for hypocalcemia.
Conclusion: Intraoperative PTH may be useful in predicting hypocalcemia in children after total thyroidectomy. No consistent clinical risk factors or preventative methods were identified in the pediatric literature. High-quality pediatric research is urgently required to address this knowledge gap.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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