Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study
Objective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papi...
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| Veröffentlicht in: | International journal of endocrinology 2020, Vol.2020 (2020), p.1-9, Article 7189857 |
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| creator | Wang, Wendong Wang, Peng Gu, JiaLei Wang, KeJing Shang, JinBiao Mo, Kangnan Nie, Xilin |
| description | Objective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papillary thyroid carcinoma. Setting. Patients were recruited between January 2016 and June 2018. Subjects and Methods. Patients who underwent bilateral (n = 155, bilateral group) and ipsilateral CLND (n = 21) after total thyroidectomy were included. The preoperative and postoperative parathyroid hormone (PTH) and calcium levels were detected. The risk factors for transient hypocalcemia were identified using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results. Fifty-one (28.98%) patients developed transient hypocalcemia, and 2 patients (1.14%) developed permanent hypoparathyroidism. There was no difference in the gender ratio or the morbidity of hypocalcemia between the patients who underwent bilateral and ipsilateral CLND. On postoperative day 1, PTH decrease was a risk factor for transient hypocalcemia in the whole cohort (β = 0.043, OR = 1.044, 95% CI 1.023–1.065, p |
| doi_str_mv | 10.1155/2020/7189857 |
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We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papillary thyroid carcinoma. Setting. Patients were recruited between January 2016 and June 2018. Subjects and Methods. Patients who underwent bilateral (n = 155, bilateral group) and ipsilateral CLND (n = 21) after total thyroidectomy were included. The preoperative and postoperative parathyroid hormone (PTH) and calcium levels were detected. The risk factors for transient hypocalcemia were identified using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results. Fifty-one (28.98%) patients developed transient hypocalcemia, and 2 patients (1.14%) developed permanent hypoparathyroidism. There was no difference in the gender ratio or the morbidity of hypocalcemia between the patients who underwent bilateral and ipsilateral CLND. On postoperative day 1, PTH decrease was a risk factor for transient hypocalcemia in the whole cohort (β = 0.043, OR = 1.044, 95% CI 1.023–1.065, p<0.001), bilateral group (β = 0.042, OR = 1.043, 95% CI 1.022–1.064, p<0.001), and female patients (β = 0.049, OR = 1.050, 95% CI 1.026–1.075, p<0.001). Tumor diameter was a risk factor for transient hypocalcemia in female patients (β = 0.499, OR = 1.647, 95% CI 1.003–2.704, p=0.049). The ROC curve analysis illustrated that 65.58%, 71.00%, and 71.00% PTH level reduction had high accuracy in predicting transient hypocalcemia in the whole cohort, bilateral group, and female patients, respectively (AUC = 0.986, 0.987, and 0.987). Conclusion. Asymptomatic female patients with bilateral CLND and a 71.00% PTH level reduction were at a high risk of transient hypocalcemia.</description><identifier>ISSN: 1687-8337</identifier><identifier>EISSN: 1687-8345</identifier><identifier>DOI: 10.1155/2020/7189857</identifier><identifier>PMID: 32802056</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Age ; Analysis ; Asymptomatic ; Clinical Study ; Dissection ; Endocrinology ; Endocrinology & Metabolism ; Gender ; Hospitals ; Hypocalcemia ; Life Sciences & Biomedicine ; Lymphatic system ; Medical research ; Medicine, Experimental ; Parathyroid hormone ; Pathology ; Risk factors ; Science & Technology ; Surgeons ; Surgery ; Thyroid cancer ; Thyroid diseases ; Thyroidectomy ; Tuberculosis</subject><ispartof>International journal of endocrinology, 2020, Vol.2020 (2020), p.1-9, Article 7189857</ispartof><rights>Copyright © 2020 Kangnan Mo et al.</rights><rights>COPYRIGHT 2020 John Wiley & Sons, Inc.</rights><rights>Copyright © 2020 Kangnan Mo et al. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2020 Kangnan Mo et al. 2020</rights><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>9</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000561414500001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c635t-f39758af68cb96487e6933614d8c97357282e3c5d32efef446a85ac5a9b0f9c53</citedby><cites>FETCH-LOGICAL-c635t-f39758af68cb96487e6933614d8c97357282e3c5d32efef446a85ac5a9b0f9c53</cites><orcidid>0000-0002-2079-2709 ; 0000-0003-3580-1222</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416261/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416261/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,878,886,2103,2115,4025,27928,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32802056$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Rosato, Lodovico</contributor><contributor>Lodovico Rosato</contributor><creatorcontrib>Wang, Wendong</creatorcontrib><creatorcontrib>Wang, Peng</creatorcontrib><creatorcontrib>Gu, JiaLei</creatorcontrib><creatorcontrib>Wang, KeJing</creatorcontrib><creatorcontrib>Shang, JinBiao</creatorcontrib><creatorcontrib>Mo, Kangnan</creatorcontrib><creatorcontrib>Nie, Xilin</creatorcontrib><title>Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study</title><title>International journal of endocrinology</title><addtitle>INT J ENDOCRINOL</addtitle><addtitle>Int J Endocrinol</addtitle><description>Objective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papillary thyroid carcinoma. Setting. Patients were recruited between January 2016 and June 2018. Subjects and Methods. Patients who underwent bilateral (n = 155, bilateral group) and ipsilateral CLND (n = 21) after total thyroidectomy were included. The preoperative and postoperative parathyroid hormone (PTH) and calcium levels were detected. The risk factors for transient hypocalcemia were identified using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results. Fifty-one (28.98%) patients developed transient hypocalcemia, and 2 patients (1.14%) developed permanent hypoparathyroidism. There was no difference in the gender ratio or the morbidity of hypocalcemia between the patients who underwent bilateral and ipsilateral CLND. On postoperative day 1, PTH decrease was a risk factor for transient hypocalcemia in the whole cohort (β = 0.043, OR = 1.044, 95% CI 1.023–1.065, p<0.001), bilateral group (β = 0.042, OR = 1.043, 95% CI 1.022–1.064, p<0.001), and female patients (β = 0.049, OR = 1.050, 95% CI 1.026–1.075, p<0.001). Tumor diameter was a risk factor for transient hypocalcemia in female patients (β = 0.499, OR = 1.647, 95% CI 1.003–2.704, p=0.049). The ROC curve analysis illustrated that 65.58%, 71.00%, and 71.00% PTH level reduction had high accuracy in predicting transient hypocalcemia in the whole cohort, bilateral group, and female patients, respectively (AUC = 0.986, 0.987, and 0.987). Conclusion. Asymptomatic female patients with bilateral CLND and a 71.00% PTH level reduction were at a high risk of transient hypocalcemia.</description><subject>Age</subject><subject>Analysis</subject><subject>Asymptomatic</subject><subject>Clinical Study</subject><subject>Dissection</subject><subject>Endocrinology</subject><subject>Endocrinology & Metabolism</subject><subject>Gender</subject><subject>Hospitals</subject><subject>Hypocalcemia</subject><subject>Life Sciences & Biomedicine</subject><subject>Lymphatic system</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Parathyroid hormone</subject><subject>Pathology</subject><subject>Risk factors</subject><subject>Science & Technology</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Thyroid cancer</subject><subject>Thyroid diseases</subject><subject>Thyroidectomy</subject><subject>Tuberculosis</subject><issn>1687-8337</issn><issn>1687-8345</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>AOWDO</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>DOA</sourceid><recordid>eNqNkt1rFDEUxQdRrFbffJYBQQTdNpl8jg9CWdQWCha7Pods5mY3ZXayZjIt61_vHbduu-JDmYcJye-em5x7iuIVJUeUCnFckYocK6prLdSj4hmVWk004-Lxbs3UQfG8768IkVIS-rQ4YJXGKiGfFb8ubLJ5uUkxNOVpTKvYQfkdmsHlELvyIkETXO7LWbJdH6DL5elmHZ1tHayCLa3PkMpZzLYtZ1sVcDmuNh_Lk_IydIsWJlOsQugixX6Nh-Eayss8NJsXxRNv2x5e3v4Pix9fPs-mp5Pzb1_PpifnEyeZyBPPaiW09VK7eS25ViBrxiTljXa1YkJVugLmRMMq8OA5l1YL64St58TXTrDD4myr20R7ZdYprGzamGiD-bMR08LYlINrwUjpscSx2kvFCaeagWrm4JSQ84pWDWp92mqth_kKGodPS7bdE90_6cLSLOK1UZzKSlIUeHcrkOLPAfpsVqF30La2gzj0puKMYzfBGKJv_kGv4pA6tGqkKJqC4B21sPiA0PmIfd0oak4kqyvFNOdIHf2Hwq_BMTqcuQ-4v1fw9l7BEmybl31shzEV_T74YQs6nG-fwO_MoMSMATVjQM1tQBF_fd_AHfw3kQi83wI3MI--d5g5BzuMEGQop1zgiox26ofT05DteP9pHLp812gZusbehAfeG5ABb-9oqggXgv0Gwy0XHg</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Wang, Wendong</creator><creator>Wang, Peng</creator><creator>Gu, JiaLei</creator><creator>Wang, KeJing</creator><creator>Shang, JinBiao</creator><creator>Mo, Kangnan</creator><creator>Nie, Xilin</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>Hindawi Publishing Group</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2079-2709</orcidid><orcidid>https://orcid.org/0000-0003-3580-1222</orcidid></search><sort><creationdate>2020</creationdate><title>Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study</title><author>Wang, Wendong ; Wang, Peng ; Gu, JiaLei ; Wang, KeJing ; Shang, JinBiao ; Mo, Kangnan ; Nie, Xilin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c635t-f39758af68cb96487e6933614d8c97357282e3c5d32efef446a85ac5a9b0f9c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Analysis</topic><topic>Asymptomatic</topic><topic>Clinical Study</topic><topic>Dissection</topic><topic>Endocrinology</topic><topic>Endocrinology & Metabolism</topic><topic>Gender</topic><topic>Hospitals</topic><topic>Hypocalcemia</topic><topic>Life Sciences & Biomedicine</topic><topic>Lymphatic system</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Parathyroid hormone</topic><topic>Pathology</topic><topic>Risk factors</topic><topic>Science & Technology</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Thyroid cancer</topic><topic>Thyroid diseases</topic><topic>Thyroidectomy</topic><topic>Tuberculosis</topic><toplevel>online_resources</toplevel><creatorcontrib>Wang, Wendong</creatorcontrib><creatorcontrib>Wang, Peng</creatorcontrib><creatorcontrib>Gu, JiaLei</creatorcontrib><creatorcontrib>Wang, KeJing</creatorcontrib><creatorcontrib>Shang, JinBiao</creatorcontrib><creatorcontrib>Mo, Kangnan</creatorcontrib><creatorcontrib>Nie, Xilin</creatorcontrib><collection>الدوريات العلمية والإحصائية - e-Marefa Academic and Statistical Periodicals</collection><collection>معرفة - المحتوى العربي الأكاديمي المتكامل - e-Marefa Academic Complete</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access</collection><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>International journal of endocrinology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Wendong</au><au>Wang, Peng</au><au>Gu, JiaLei</au><au>Wang, KeJing</au><au>Shang, JinBiao</au><au>Mo, Kangnan</au><au>Nie, Xilin</au><au>Rosato, Lodovico</au><au>Lodovico Rosato</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study</atitle><jtitle>International journal of endocrinology</jtitle><stitle>INT J ENDOCRINOL</stitle><addtitle>Int J Endocrinol</addtitle><date>2020</date><risdate>2020</risdate><volume>2020</volume><issue>2020</issue><spage>1</spage><epage>9</epage><pages>1-9</pages><artnum>7189857</artnum><issn>1687-8337</issn><eissn>1687-8345</eissn><abstract>Objective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papillary thyroid carcinoma. Setting. Patients were recruited between January 2016 and June 2018. Subjects and Methods. Patients who underwent bilateral (n = 155, bilateral group) and ipsilateral CLND (n = 21) after total thyroidectomy were included. The preoperative and postoperative parathyroid hormone (PTH) and calcium levels were detected. The risk factors for transient hypocalcemia were identified using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results. Fifty-one (28.98%) patients developed transient hypocalcemia, and 2 patients (1.14%) developed permanent hypoparathyroidism. There was no difference in the gender ratio or the morbidity of hypocalcemia between the patients who underwent bilateral and ipsilateral CLND. On postoperative day 1, PTH decrease was a risk factor for transient hypocalcemia in the whole cohort (β = 0.043, OR = 1.044, 95% CI 1.023–1.065, p<0.001), bilateral group (β = 0.042, OR = 1.043, 95% CI 1.022–1.064, p<0.001), and female patients (β = 0.049, OR = 1.050, 95% CI 1.026–1.075, p<0.001). Tumor diameter was a risk factor for transient hypocalcemia in female patients (β = 0.499, OR = 1.647, 95% CI 1.003–2.704, p=0.049). The ROC curve analysis illustrated that 65.58%, 71.00%, and 71.00% PTH level reduction had high accuracy in predicting transient hypocalcemia in the whole cohort, bilateral group, and female patients, respectively (AUC = 0.986, 0.987, and 0.987). Conclusion. Asymptomatic female patients with bilateral CLND and a 71.00% PTH level reduction were at a high risk of transient hypocalcemia.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>32802056</pmid><doi>10.1155/2020/7189857</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2079-2709</orcidid><orcidid>https://orcid.org/0000-0003-3580-1222</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Analysis Asymptomatic Clinical Study Dissection Endocrinology Endocrinology & Metabolism Gender Hospitals Hypocalcemia Life Sciences & Biomedicine Lymphatic system Medical research Medicine, Experimental Parathyroid hormone Pathology Risk factors Science & Technology Surgeons Surgery Thyroid cancer Thyroid diseases Thyroidectomy Tuberculosis |
| title | Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study |
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