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Risk of Permanent Hypoparathyroidism after Total Thyroidectomy for Benign Disease A Nationwide Population-based Cohort Study from Sweden

Annebäck, Matilda ; Hedberg, Jakob ; Almquist, Martin LU ; Stålberg, Peter and Norlén, Olov (2021) In Annals of Surgery 274(6). p.1202-1208
Abstract

Objective: To investigate the prevalence and risk factors for permanent hypoparathyroidism after total thyroidectomy for benign disease in a population- based setting with data independent of input of complication data. Summary of Background Data: The reported rate of permanent hypoparathyroidism is highly variable and mostly rely on reported complication data from national or institutional registries. Methods: All patients who underwent total thyroidectomy in Sweden from 2005 to 2015 were identified through Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery and the Swedish National Patient Register. Patients were matched to outcome data from the Swedish Prescribed Drug Register. Permanent hypoparathyroidism was... (More)

Objective: To investigate the prevalence and risk factors for permanent hypoparathyroidism after total thyroidectomy for benign disease in a population- based setting with data independent of input of complication data. Summary of Background Data: The reported rate of permanent hypoparathyroidism is highly variable and mostly rely on reported complication data from national or institutional registries. Methods: All patients who underwent total thyroidectomy in Sweden from 2005 to 2015 were identified through Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery and the Swedish National Patient Register. Patients were matched to outcome data from the Swedish Prescribed Drug Register. Permanent hypoparathyroidism was defined as treatment with calcium and/or active vitamin D more than 1 year after surgery. Results: Seven thousand eight hundred fifty-two patients were included and 938 (12.5%) developed permanent hypoparathyroidism. The risk was lower in patients registered in the quality register (11.0% vs 16%, P < 0.001). In a multivariable analysis there was a higher risk of permanent hypoparathyroidism in patients with parathyroid autotransplantation [Odds ratio (OR) 1.72; 95% confidence interval 1.47-2.01], center-volume <100 thyroidectomies per year (OR 1.22; 1.03-1.44), age above 60 year (OR 1.64; 1.36-1.98) and female sex (OR 1.27; 1.05-1.54). Reported data from the quality register only identified 178 of all 938 patients with permanent hypoparathyroidism. Conclusion: The risk of permanent hypoparathyroidism after total thyroidectomy was high and associated with parathyroid autotransplantation, higher age, female sex and surgery at a low volume center. Reported follow-up data might underestimate the rate of permanent hypoparathyroidism.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Permanent hypoparathyroidism, Thyroidectomy
in
Annals of Surgery
volume
274
issue
6
pages
1202 - 1208
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:32032086
  • scopus:85121969372
ISSN
0003-4932
DOI
10.1097/SLA.0000000000003800
language
English
LU publication?
yes
id
ab29dbe6-233a-4956-a662-5874d1c23745
date added to LUP
2022-02-21 14:44:08
date last changed
2024-04-18 06:50:41
@article{ab29dbe6-233a-4956-a662-5874d1c23745,
  abstract     = {{<p>Objective: To investigate the prevalence and risk factors for permanent hypoparathyroidism after total thyroidectomy for benign disease in a population- based setting with data independent of input of complication data. Summary of Background Data: The reported rate of permanent hypoparathyroidism is highly variable and mostly rely on reported complication data from national or institutional registries. Methods: All patients who underwent total thyroidectomy in Sweden from 2005 to 2015 were identified through Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery and the Swedish National Patient Register. Patients were matched to outcome data from the Swedish Prescribed Drug Register. Permanent hypoparathyroidism was defined as treatment with calcium and/or active vitamin D more than 1 year after surgery. Results: Seven thousand eight hundred fifty-two patients were included and 938 (12.5%) developed permanent hypoparathyroidism. The risk was lower in patients registered in the quality register (11.0% vs 16%, P &lt; 0.001). In a multivariable analysis there was a higher risk of permanent hypoparathyroidism in patients with parathyroid autotransplantation [Odds ratio (OR) 1.72; 95% confidence interval 1.47-2.01], center-volume &lt;100 thyroidectomies per year (OR 1.22; 1.03-1.44), age above 60 year (OR 1.64; 1.36-1.98) and female sex (OR 1.27; 1.05-1.54). Reported data from the quality register only identified 178 of all 938 patients with permanent hypoparathyroidism. Conclusion: The risk of permanent hypoparathyroidism after total thyroidectomy was high and associated with parathyroid autotransplantation, higher age, female sex and surgery at a low volume center. Reported follow-up data might underestimate the rate of permanent hypoparathyroidism. </p>}},
  author       = {{Annebäck, Matilda and Hedberg, Jakob and Almquist, Martin and Stålberg, Peter and Norlén, Olov}},
  issn         = {{0003-4932}},
  keywords     = {{Permanent hypoparathyroidism; Thyroidectomy}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{6}},
  pages        = {{1202--1208}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Annals of Surgery}},
  title        = {{Risk of Permanent Hypoparathyroidism after Total Thyroidectomy for Benign Disease A Nationwide Population-based Cohort Study from Sweden}},
  url          = {{http://dx.doi.org/10.1097/SLA.0000000000003800}},
  doi          = {{10.1097/SLA.0000000000003800}},
  volume       = {{274}},
  year         = {{2021}},
}