ORIGINAL ARTICLE

Factors Affecting Incidence of Hypocalcemia Post Thyroid Surgery
Tiroid Ameliyatı Sonrası Hipokalsemi İnsidansını Etkileyen Faktörler
Received Date : 05 Apr 2021
Accepted Date : 09 Nov 2021
Available Online : 18 Oct 2021
Doi: 10.25179/tjem.2021-83669 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:370-378
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Thyroid surgery is a common surgical procedure. Hypocalcemia after thyroid surgery continues to be a significant medical complication. The present study evaluates the rate of transient hypocalcemia (TH) and permanent hypocalcemia (PH) post thyroid surgery and investigates the predictive factors behind its development. Material and Methods: In this study, we retrospectively evaluated 2,381 cases who underwent thyroidectomy between the years 2009 and 2019. TH and PH were assessed based on clinicopathological features. Results: The mean age of patients included in this study was 45 (14-87) years; 35.8% were under the age of 40 83.6% were females. The rate of incidental parathyroidectomy (confirmed by pathology reports) was 9.7% (n=199). TH and PH developed in 16.1% (n=316) and 5.1% (n=105) of the cases, respectively. Incidental parathyroidectomy and total thyroidectomy [odds ratio (OR) 95% confidence interval (CI); 1.767, 3.017] can be considered independent risk factors for the development of TH. Age, gender, absence of preoperative hyperthyroidism, total thyroidectomy, Hashimoto thyroiditis, thyroid gland volume, and incidental parathyroidectomy are the risk factors for the development of PH [OR (95% CI); 0.981, 3.695, 2.65, 4.270, 1.741 1.002, 2.235]. Conclusion: The incidence of permanent hypocalcemia development in patients with preoperative hyperthyroidism is low.
ÖZET
Amaç: Tiroid cerrahisi yaygın bir cerrahi girişimdir. Tiroid cerrahisi sonrası hipokalsemi önemli bir tıbbi komplikasyon olmaya devam etmektedir. Bu çalışma, tiroid cerrahisi sonrası geçici ve kalıcı hipokalsemi oranlarını değerlendirmekte ve gelişiminin arkasındaki öngörücü faktörleri araştırmaktadır. Gereç ve Yöntemler: Bu çalışmada, 2009-2019 yılları arasında tiroidektomi yapılan 2.381 olgu retrospektif olarak değerlendirildi. Geçici ve kalıcı hipokalsemi, klinik ve patolojik özelliklere göre değerlendirildi. Bulgular: Bu çalışmaya dâhil edilen hastaların ortalama yaşı 45 (14-87), %35,8’i 40 yaşın altında ve %83,6’sı kadındı. İnsidental paratiroidektomi oranı (patoloji raporları ile doğrulanan) %9,7 (n=199) idi. Olguların sırasıyla %16,1’inde (n=316) ve %5,1’inde (n=105) geçici ve kalıcı hipokalsemi gelişti. İnsidental paratiroidektomi ve total tiroidektomi [göreceli olasılıklar oranı [odds ratio (OR)] %95 güven aralığı (GA); 1,767, 3,017] geçici hipokalsemi gelişimi için bağımsız risk faktörleri olarak saptandı. Yaş, cinsiyet, preoperatif hipertiroidi olmaması, total tiroidektomi, Hashimoto tiroiditi, tiroid bezi hacmi ve insidental paratiroidektomi kalıcı hipokalsemi gelişimi için risk faktörleri olarak saptandı [OR (%95 GA); 0,981, 3,695, 2,65, 4,270, 1,741 1,002, 2,235]. Sonuç: Preoperatif hipertiroidili hastalarda kalıcı hipokalsemi gelişme insidansı düşüktür.
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