Stratifying the risk factors for hypoparathyroidism after total thyroidectomy

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COD: 01_2019_05_2872 Categorie: ,

Narin Nasiroglu Imga, Hakan Atas, Murat Torgutalp, Gul Daglar, Dilek Berker

Ann. Ital. Chir., 2019 90, 1: 21-30

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BACKGROUND: Post-operative hypoparathyroidism is a complication in patients who undergo thyroid surgery. Our study
aimed to evaluate the incidence and causes of post-operative transient and permanent hypoparathyroidism in patients
undergoing thyroid surgery.
MATERIALS AND METHODS: The data of 933 consecutive patients who underwent total thyroidectomy in a single center
were retrospectively evaluated. The rate of post-operative hypoparathyroidism, clinicopathological features, and laboratory
parameters during the post-operative first day, first month, and first year of patients with and without hypoparathyroidism
were analyzed. Patients with hypoparathyroidism were classified as transient or permanent cases.
RESULTS: The incidence of post-operative hypoparathyroidism was 22.7%, including transient (20.6%) and permanent
(2.1%). In multivariable analysis, independent predictors of permanent hypoparathyroidism were as follows: surgery due
to malignant thyroid disease, tumor multifocality, and pre-operative vitamin-D deficiency (VDD) (p<0.001, 0.047, and 0.002, respectively). During the post-operative first month, the mean serum PTH levels were found to be 7.58 pg/mL, and they remained low on the post-operative first year in patients with permanent hypoparathyroidism. CONCLUSION: Surgery due to thyroid malignancy and VDD should be considered risk factors for permanent hypoparathyroidism in patients who undergothyroid surgery. The post-operative first month is important in the prediction of permanent hypoparathyroidism.