Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration
| Autor: | Mohammed Alessa, Samiah S. Al-Angari, Saleh F. Aldhahri, Jabir Alharbi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty Hormone Replacement Therapy Initial dose medicine.medical_treatment Urology Levothyroxine Continuous variable 03 medical and health sciences Postoperative Complications 0302 clinical medicine Hypothyroidism medicine Humans Drug Dosage Calculations 030223 otorhinolaryngology Aged Retrospective Studies Postoperative Care Body surface area Polynomial regression Total thyroidectomy Dose-Response Relationship Drug business.industry Thyroidectomy General Medicine Middle Aged Thyroxine Otorhinolaryngology 030220 oncology & carcinogenesis Female business Algorithms medicine.drug |
| Zdroj: | European Archives of Oto-Rhino-Laryngology. 276:2559-2564 |
| ISSN: | 1434-4726 0937-4477 |
| DOI: | 10.1007/s00405-019-05523-4 |
| Popis: | As the lack of consensus in the initial levothyroxine (LT4) dose titration following total thyroidectomy exists, the aim of this study was to identify and quantify predictive factors for LT4 dose replacement. A retrospective analysis of a prospectively gathered data of 234 patients who underwent total-thyroidectomy at two institutions between November 9, 2009 and January 1, 2016 was conducted. Outcome variable was the clinically observed optimal LT4 dose. Linear and polynomial regression methods were used for prediction. Continuous variables were tested for mean differences using Student’s t-test and association using Pearson’s correlation. We identified Body Surface Area (BSA) as the most significant predictor. We propose a model that titrates LT4 dose based on BSA (1.4 µg /kg/day for BSA > 1.79 m2 vs. 1.7 µg /kg/day for BSA ≤ 1.79 m2; P = 0.00). Men required higher doses than women and no differences were noted based on DM status or pathological diagnosis. Our analysis shows BSA as an independent predictor of LT4 dose post total thyroidectomy. Despite the possibility of generating different equations for predicting LT4 post total-thyroidectomy, finding a practical and clinically relevant prediction model is yet of limited efficiency. |
| Databáze: | OpenAIRE |
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