Incidence,Risk Factors,and Clinical Implications of Delayed Hypoparathyroidism on Postoperative Day two Following Total Thyroidectomy for Papillary Thyroid Carcinoma |
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| Institution: | 1. From the Division of Breast & Thyroid Surgical Oncology, Department of Surgery, College of Medicine, St. Vincent''s Hospital, The Catholic University of Korea, Gyeonggi-do, Republic of Korea.;1. University of New Mexico Health Sciences Center, Department of Internal Medicine, Division of Endocrinology;2. University of New Mexico Health Sciences Center, Department of Pharmaceutical Sciences, Albuquerque, New Mexico.;1. Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, Florida;2. Department of Medicine, Mayo Clinic, Jacksonville, Florida;3. Division of Perioperative Medicine and Anesthesia, Mayo Clinic, Jacksonville, Florida;4. Division of Endocrinology, Department of Medicine. Mayo Clinic, Scottsdale, Arizona;5. Division of Allergic Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota;6. Division of Endocrinology, Department of Medicine, Mayo Clinic, Jacksonville, Florida.;1. Department of Endocrinology;2. Department of Gastroenterology and Hepatology, David Grant Medical Center, Travis Air Force Base, California. |
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| Abstract: | Objective: This study aimed to investigate the incidence rates, risk factors, and clinical implications of delayed hypoparathyroidism on postoperative day 2 (POD-2) after total thyroidectomy in patients with papillary thyroid carcinoma.Methods: This study included 410 patients with normal serum intact parathyroid hormone (iPTH) and calcium levels on postoperative day 1 (POD-1) who were classified into 2 groups according to the presence or absence of delayed hypoparathyroidism on POD-2.Results: Of the 410 patients, 98 experienced delayed hypoparathyroidism on POD-2 (23.9%). The significant risk factors for delayed hypoparathyroidism on POD-2 included female gender, age older than 45 years, central lymph node dissection, increased number of excised lymph nodes, and low POD-1 versus preoperative iPTH ratios. Additionally, delayed hypoparathyroidism on POD-2 was found to be a significant risk factor for hypocalcemia on POD-2 and permanent hypoparathyroidism.Conclusion: Prophylactic calcium supplementation and long-term surveillance for permanent hypoparathyroidism should be considered in patients with risk factors for delayed hypoparathyroidism on POD-2.Abbreviations: CI = confidence interval; iPTH = intact parathyroid hormone; OR = odds ratio; POD-1 = postoperative day 1; POD-2 = postoperative day 2; PTC = papillary thyroid carcinoma; ROC = receiver operating characteristic |
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