Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults.

Autor: Barbier MP; Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Mingote E; Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Sforza N; Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Morosán Allo Y; Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Lotartaro M; Servicio de Cirugía General, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Serrano L; Servicio de Cirugía General, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Fossati MP; Laboratorio Central, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Meroño T; Laboratorio de Biomarcadores y Nutrimetabolómica, Departamento de Nutrición, Ciencias de la Alimentación y Gastronomía, Red de Referencia en Tecnología de Alimentos (XaRTA), Instituto de Nutrición y Seguridad Alimentaria (INSA), Facultad de Farmacia y Ciencias de la Alimentación, Universidad de Barcelona, Barcelona, Spain.; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain., Faingold C; Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Sedlinsky C; Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina., Brenta G; Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina. gbrenta@gmail.com.
Jazyk: angličtina
Zdroj: Endocrine [Endocrine] 2022 Jan; Vol. 75 (1), pp. 276-283. Date of Electronic Publication: 2021 Aug 04.
DOI: 10.1007/s12020-021-02840-9
Abstrakt: Purpose: Transient hypocalcaemia after thyroid surgery and its possible predictors have not been extensively described in the elderly. This study aimed to establish the frequency of postsurgical transient hypocalcaemia according to the extent of thyroid surgery in older adults and to assess mineral metabolism biochemical parameters as its predictors.
Methods: All patients ≥60 years undergoing thyroid surgery were prospectively included. Type of surgery (hemithyroidectomy(HT) or total thyroidectomy(TT)); and preoperative 25OH Vitamin D (25OHD) and pre and 6 (only TT), 24 h and 6 months postsurgical serum levels of calcium, magnesium, phosphate and parathormone (PTH) were considered. Postsurgical hypoparathyroidism (hPTpost) was defined at PTH levels ≤11 pg/mL.
Results: Out of 46 patients (87% female), age (mean ± SD) 70.1 ± 6.2 years, 24 h postsurgical hypocalcaemia was found in ten patients (22%). In 25 (54%) TT patients, 36% and 16% had postsurgical hypocalcaemia at 6 and 24 h respectively; 28% hPTpost but no definitive hPT was recorded and 44% had 25OHD deficiency. Lower 24 h magnesium levels were found in those TT patients with 24 h hypocalcaemia (1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005)). Among 21 (46%) HT patients, 28.6% had 24 h postsurgical hypocalcaemia; 9.5% had hPTpost. A positive correlation was observed between preoperative 25OHD and 24 h calcaemia (r:0.51,p = 0.02). 43% of the patients were 25OHD deficient, in whom 55% had 24 h hypocalcaemia vs only 9% in the 25OHD sufficient group (p = 0.049).
Conclusion: Postsurgical hypocalcaemia was common in elderly thyroidectomized patients. After TT, lower magnesium levels were found in those patients with 24 h hypocalcaemia. In the HT group, preoperative 25OHD deficiency predicted lower postsurgical calcium levels.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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