Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis

Autor: Miguel Paja, Sergio Donnay, Emma Anda, Juan J. Díez, José Carlos Fernández García, Ana R Romero-Lluch, Orosia Bandrés, Carles Zafon, Cecilia Sánchez Ragnarsson, María Picallo, Pedro Iglesias, Juan C. Galofré, Elena Navarro, Eva Sanz, Laura Manjón, Marcel Sambo, Gloria Baena-Nieto, Cristina Álvarez-Escolá, Julia Sastre, Piedad Santiago Fernández, Manel Sahún de la Vega, Concepción Blanco Carrera, Ana Megia, Begoña Pérez Corral, Beatriz Lecumberri, Amelia Oleaga
Rok vydání: 2019
Předmět:
Zdroj: Digital.CSIC. Repositorio Institucional del CSIC
instname
ISSN: 1559-0100
1355-008X
DOI: 10.1007/s12020-019-02014-8
Popis: [Purpose]: The prevalence of postoperative hypoparathyroidism has been studied in registries and in surgical series with highly variable and imprecise results. However, the frequency of this hormonal deficiency in the clinical practice of endocrinologists is not known with accuracy. We aimed to assess the prevalence and risk factors of hypoparathyroidism in patients undergoing total thyroidectomy in Spain. [Methods]: We designed a retrospective, multicentre and nation-wide protocol including all patients with total thyroidectomy who were seen in the endocrinology clinic of the participant centers from January to March 2018. Prevalence of hypoparathyroidism was evaluated at discharge of surgery, 3–6 months after surgery, 12 months after surgery and at last visit. Twenty hospitals participated in the study. [Results]: Of 1792 patients undergoing total thyroidectomy, 866 (48.3%) developed postoperative hypoparathyroidism at discharge of surgery. Most of them recover parathyroid function over time. Prevalence of hypoparathyroidism at 3–6 months, 12 months and at last visit was 22.9%, 16.7% and 14.5%, respectively. The risk of developing definitive hypoparathyroidism was related to the presence of parathyroid tissue at histology, lymph node dissection, and two-stage thyroidectomy. Patients with thyroid cancer, with higher postoperative calcium levels and treated by expert surgical teams exhibited lower risk of developing permanent hypoparathyroidism. [Conclusions]: Although most patients with postsurgical hypoparathyroidism recover parathyroid function, the prevalence of permanent disease in clinical practice is non negligible (14.5%). Postoperative calcium, extent and timing of surgery, the presence of cancer, expert surgical team, and parathyroid tissue at histology are predictors of permanent hypoparathyroidism.
Databáze: OpenAIRE
Externí odkaz: