| Title |
Predictors of postoperative hypocalcemia occurring after a total thyroidectomy: results of prospective multicenter study
|
|---|---|
| Published in |
BMC Surgery, August 2018
|
| DOI | 10.1186/s12893-018-0387-2 |
| Pubmed ID | |
| Authors |
Vitalijus Eismontas, Algirdas Slepavicius, Vinsas Janusonis, Paulius Zeromskas, Virgilijus Beisa, Kestutis Strupas, Zilvinas Dambrauskas, Antanas Gulbinas, Arvydas Martinkenas |
| Abstract |
Thyroid surgeries are among the most common operations performed in the world. Hypocalcemia following total thyroidectomy is a common complication that is sometimes difficult to correct. The aim of this study is to determine the risk factors for hypocalcemia following total thyroidectomy and their clinical value. From January 2015 through to April 2017, 400 patients were included in this prospective multicenter study. All patients underwent total thyroidectomy due to various thyroid diseases. The following risk factors were analyzed: pre-operative and post-operative biochemical blood parameters, clinical effects and factors related to surgery, the patient, and the disease. Post-operative hypocalcemia developed in 257 patients (64.2%). Of them, 197 patients (76.7%) were diagnosed with asymptomatic hypocalcemia. Clinical symptoms were present in 60 of the 257 patients with hypocalcemia (23.3%). The statistically significant predictors of hypocalcemia were decreased calcium and ionized calcium pre-operatively (p < 0.001), parathyroid hormone on day one following surgery (p < 0.001), thyrotoxicosis <10 years before surgery (odds ratio 1.65, 95% CI 1.01-2.70, p = 0.046), the number of parathyroid glands found during surgery (odds ratio 0.52, 95% CI 0.38-0.70, p < 0.001), ligation of the trunk of the left inferior thyroid artery (odds ratio 2.04, 95% CI 1.27-3.29, p = 0.003), ligation of the trunk of the right inferior thyroid artery (odds ratio 2.37, 95% CI 1.47-3.81, p < 0.001), and the number of transplanted parathyroid glands (odds ratio 1.87, 95% CI 1.12-2.97, p = 0.015). In the multivariate analysis, age (odds ratio 1.05, 95% CI 1.01-1.09, p = 0.029) and gender (odds ratio 5.94, 95% CI 1.13-31.26, p = 0.035) were statistically significant predictors. This study demonstrates that there is a number of different patient (gender, age, and duration of thyrotoxicosis <10 years before surgery) and surgical (number of parathyroid glands found during surgery, decreased calcium and ionized calcium before surgery, parathyroid hormone on day one following surgery, and ligation of the trunk of the left and right inferior thyroid artery) risk factors predictive of hypocalcemia following total thyroidectomy. Optimization of the surgical technique could possibly prevent the occurrence of hypocalcemia after total thyroidectomy in some cases; in other cases, identification of known risk factors post-operatively could permit early detection and effective treatment of these patients. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 81 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 81 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 12 | 15% |
| Student > Bachelor | 7 | 9% |
| Student > Doctoral Student | 7 | 9% |
| Other | 6 | 7% |
| Unspecified | 4 | 5% |
| Other | 18 | 22% |
| Unknown | 27 | 33% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 43% |
| Unspecified | 4 | 5% |
| Nursing and Health Professions | 3 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 2% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Other | 4 | 5% |
| Unknown | 31 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 August 2018.
All research outputs
#18,646,262
of 23,099,576 outputs
Outputs from BMC Surgery
#630
of 1,340 outputs
Outputs of similar age
#254,787
of 331,387 outputs
Outputs of similar age from BMC Surgery
#10
of 31 outputs
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