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A Cohort Study Assessing the Association Between Body Composition Parameters and Symptomatic Hypocalcemia after Total Thyroidectomy

The American surgeon(2021)SCI 4区

Ankara Univ

Cited 3|Views6
Abstract
Background Postoperative hypocalcemia is one of the major concerns following thyroidectomy and the most frequent cause of prolonged hospital stay. The aim of this study was to evaluate the relationship between body composition parameters and symptomatic hypocalcemia following total thyroidectomy. In addition, the effects of disease- and patient-related factors on hypocalcemia were investigated. Methods A total of 144 patients were prospectively included between March 2014 and September 2017. Patients were divided into 2 groups according to the presence or absence of clinical symptoms of hypocalcemia. Subsequently, the relationship between body composition parameters and hypocalcemia was evaluated. Results Postoperative hypocalcemia-related symptoms occurred in 28 patients (19.4%). Permanent hypocalcemia was not encountered in any patient. Patients with hypocalcemic symptoms were more likely to have nodules ≥40 mm (39.3% vs. 17.2%, P = .011), retrosternal goiters (25.0% vs. 7.8%, P = .017), central lymph node dissection (LND) (32.1% vs. 11.2%, P = .015), and parathyroid autotransplantation (28.6% vs. 3.4%, P < .001) than those without symptoms. However, no differences were observed in the body composition parameters between symptomatic and asymptomatic patients. On multivariate analysis, lower preoperative intact parathyroid hormone (iPTH) levels (odds ratios (ORs) .96, 95% confidence intervals (CIs) .93-.99), the presence of retrosternal goiters (OR 10.26, 95% CI 2.23-47.14), central LND (OR 16.05, 95% CI 3.90-66.07), and parathyroid autotransplantation (OR 36.22, 95% CI 6.76-194.13) predicted hypocalcemia. Discussion This study demonstrates that patients with lower preoperative iPTH levels, retrosternal goiters, central LND, and parathyroid autotransplantation are at an increased risk of developing clinical symptoms of hypocalcemia. Body composition parameters have no effect on the incidence of hypocalcemia after total thyroidectomy.
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body composition,hypocalcemia,hypoparathyroidism,thyroid,total thyroidectomy
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要点】:本研究旨在评估身体成分参数与甲状腺切除术后症状性低钙血症之间的关联,发现术前全段甲状旁腺激素水平低、胸骨后甲状腺肿、中央淋巴结清扫和甲状旁腺自体移植是症状性低钙血症的危险因素,而身体成分参数对此无影响。

方法】:通过前瞻性队列研究,将144名患者根据是否出现低钙血症的临床症状分为两组,评估身体成分参数与低钙血症的关系。

实验】:研究在2014年3月至2017年9月间进行,共纳入144名患者,其中28名患者(19.4%)出现术后低钙血症相关症状,未发现永久性低钙血症。通过多变量分析,确定了低钙血症的危险因素。