Author, as appears in the article.: Díez JJ; Anda E; Sastre J; Pérez Corral B; Álvarez-Escolá C; Manjón L; Paja M; Sambo M; Fernández PS; Carrera CB; Galofré JC; Navarro E; Zafón C; Sanz E; Oleaga A; Bandrés O; Donnay S; Megía A; Picallo M; Ragnarsson CS; Baena-Nieto G; Fernández-García JC; Lecumberri B; Vega MSdl; Romero-Lluch AR; Iglesias P
Department: Medicina i Cirurgia
URV's Author/s: Megía Colet, Ana
Keywords: Total thyroidectomy Thyroidectomy Permanent hypoparathyroidism Parathyroid hormone (pth) Adequacy of control thyroidectomy statement risk postsurgical hypoparathyroidism parathyroid-hormone parathyroid hormone (pth) management hypocalcemia follow-up association adequacy of control
Abstract: © 2020 © Gland Surgery. All rights reserved. Background: Recent guidelines for the treatment of hypoparathyroidism emphasize the need for long-term disease control, avoiding symptoms and hypocalcaemia. Our aim has been to analyze the prevalence of poor disease control in a national cohort of patients with hypoparathyroidism, as well as to evaluate predictive variables of inadequate disease control. Methods: From a nation-wide observational study including a cohort of 1792 patients undergoing total thyroidectomy, we selected 260 subjects [207 women and 53 men, aged (mean ± SD) 47.2±14.8 years] diagnosed with permanent hypoparathyroidism. In every patient demographic data and details on surgical procedure, histopathology, calcium (Ca) metabolism, and therapy with Ca and calcitriol were retrospectively collected. A patient was considered not adequately controlled (NAC) if presented symptoms of hypocalcemia or biochemical data showing low serum Ca levels or high urinary Ca excretion. Results: Two hundred and twenty-one (85.0%) patients were adequately controlled (AC) and 39 (15.0%) were NAC. Comparison between AC and NAC patients did not show any significant difference in demographic, surgical, and pathological features. Rate of hospitalization during follow-up was significantly higher among NAC patients in comparison with AC patients (35.9% vs. 10.9%, P<0.001). Dose of oral Ca and calcitriol were also significantly higher in NAC subjects. In a subgroup of 129 patients with serum parathyroid hormone (PTH) levels available, we found that NAC patients exhibited significantly lower postoperative PTH concentrations than AC patients [median (interquartile range) 3 (1.9–7.8) vs. 6.9 (3.0–11) pg/mL; P=0.009]. Conclusions: In a nation-wide cohort of 260 subjects with definitive hypoparathyroidism, 15% of them had poor disease control. These patients required higher doses of oral Ca and calcitriol, had higher rate of hospitalization during follow-up and showed lower PTH concentrations in the postoperative period.
Thematic Areas: Surgery Medicina i Biotecnología
licence for use: https://creativecommons.org/licenses/by/3.0/es/
Author's mail: ana.megia@urv.cat
Author identifier: 0000-0002-5101-9452
Record's date: 2023-02-19
Papper version: info:eu-repo/semantics/publishedVersion
Papper original source: Gland Surgery. 9 (5): 1380-1388
APA: Díez JJ; Anda E; Sastre J; Pérez Corral B; Álvarez-Escolá C; Manjón L; Paja M; Sambo M; Fernández PS; Carrera CB; Galofré JC; Navarro E; Zafón C; Sanz (2020). Permanent postoperative hypoparathyroidism: an analysis of prevalence and predictive factors for adequacy of control in a cohort of 260 patients. Gland Surgery, 9(5), 1380-1388. DOI: 10.21037/gs-20-288
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Entity: Universitat Rovira i Virgili
Journal publication year: 2020
Publication Type: Journal Publications
Repositori URV