How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis
Background: Postsurgical hypoparathyroidism (PH) is the most common side effect of bilateral thyroid resections. Data regarding the time course of recovery from PH are currently unavailable. Therefore, a detailed analysis of the time course of PH recovery and conditions associated with rapid recover...
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/11/3202 |
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| author | Laura Guglielmetti Sina Schmidt Mirjam Busch Joachim Wagner Ali Naddaf Barbara Leitner Simone Harsch Andreas Zielke Constantin Smaxwil |
| author_facet | Laura Guglielmetti Sina Schmidt Mirjam Busch Joachim Wagner Ali Naddaf Barbara Leitner Simone Harsch Andreas Zielke Constantin Smaxwil |
| author_sort | Laura Guglielmetti |
| collection | DOAJ |
| description | Background: Postsurgical hypoparathyroidism (PH) is the most common side effect of bilateral thyroid resections. Data regarding the time course of recovery from PH are currently unavailable. Therefore, a detailed analysis of the time course of PH recovery and conditions associated with rapid recovery was conducted. Methods: This is a retrospective analysis of prospectively documented data. Patients with biochemical signs of PH or need for calcium supplementation were followed-up for 12 months. Logistic regression analyses were used to identify covariates of early as opposed to late recovery from PH. Results: There were 1097 thyroid resections performed from 06/2015 to 07/2016 with n = 143 PH. Median recovery time was 8 weeks and six patients (1.1% of total thyroid resections) required calcium supplementation > 12 months. Recovery of PH within 4 and 12 weeks was characterized by high PTH levels on the first postoperative day (4 weeks: OR 1.13, 95% CI 1.06–1.20; 12 weeks: OR 1.08, 95%CI 1.01–1.16). Visualization of all PTGs emerged as an independent predictor of recovery within 12 months (OR 2.32, 95% CI 1.01–4.93) and 24 weeks (OR 2.69, 95% CI 1.08–6.69). Conclusion: In the setting of specialized high-volume endocrine surgery, permanent PH is rare. However, every second patient will require more than 2 months of continued medical surveillance. Early recovery was associated with only moderately decreased postsurgical PTH-levels. Successful late recovery appeared to be associated with the number of parathyroid glands visualized during surgery. |
| first_indexed | 2024-03-10T01:10:04Z |
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| last_indexed | 2024-03-10T01:10:04Z |
| publishDate | 2022-06-01 |
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| spelling | doaj.art-2f453bc828014ac1a6d60f17afbcc8442023-11-23T14:18:34ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011111320210.3390/jcm11113202How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course AnalysisLaura Guglielmetti0Sina Schmidt1Mirjam Busch2Joachim Wagner3Ali Naddaf4Barbara Leitner5Simone Harsch6Andreas Zielke7Constantin Smaxwil8Department of Surgery, Kantonsspital Winterthur, 8400 Winterthur, SwitzerlandDepartment of Surgery, Kantonsspital Winterthur, 8400 Winterthur, SwitzerlandDepartment of Endocrine Surgery, Endocrine Center Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Endocrine Surgery, Endocrine Center Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Endocrine Surgery, Endocrine Center Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyOutcomes Research Unit, Endocrine Center Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgard, GermanyOutcomes Research Unit, Endocrine Center Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgard, GermanyDepartment of Endocrine Surgery, Endocrine Center Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Endocrine Surgery, Endocrine Center Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyBackground: Postsurgical hypoparathyroidism (PH) is the most common side effect of bilateral thyroid resections. Data regarding the time course of recovery from PH are currently unavailable. Therefore, a detailed analysis of the time course of PH recovery and conditions associated with rapid recovery was conducted. Methods: This is a retrospective analysis of prospectively documented data. Patients with biochemical signs of PH or need for calcium supplementation were followed-up for 12 months. Logistic regression analyses were used to identify covariates of early as opposed to late recovery from PH. Results: There were 1097 thyroid resections performed from 06/2015 to 07/2016 with n = 143 PH. Median recovery time was 8 weeks and six patients (1.1% of total thyroid resections) required calcium supplementation > 12 months. Recovery of PH within 4 and 12 weeks was characterized by high PTH levels on the first postoperative day (4 weeks: OR 1.13, 95% CI 1.06–1.20; 12 weeks: OR 1.08, 95%CI 1.01–1.16). Visualization of all PTGs emerged as an independent predictor of recovery within 12 months (OR 2.32, 95% CI 1.01–4.93) and 24 weeks (OR 2.69, 95% CI 1.08–6.69). Conclusion: In the setting of specialized high-volume endocrine surgery, permanent PH is rare. However, every second patient will require more than 2 months of continued medical surveillance. Early recovery was associated with only moderately decreased postsurgical PTH-levels. Successful late recovery appeared to be associated with the number of parathyroid glands visualized during surgery.https://www.mdpi.com/2077-0383/11/11/3202thyroid surgerypostsurgical hypoparathyroidismrisk-factor analysistime course |
| spellingShingle | Laura Guglielmetti Sina Schmidt Mirjam Busch Joachim Wagner Ali Naddaf Barbara Leitner Simone Harsch Andreas Zielke Constantin Smaxwil How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis Journal of Clinical Medicine thyroid surgery postsurgical hypoparathyroidism risk-factor analysis time course |
| title | How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis |
| title_full | How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis |
| title_fullStr | How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis |
| title_full_unstemmed | How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis |
| title_short | How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis |
| title_sort | how long does it take to regain normocalcaemia in the event of postsurgical hypoparathyroidism a detailed time course analysis |
| topic | thyroid surgery postsurgical hypoparathyroidism risk-factor analysis time course |
| url | https://www.mdpi.com/2077-0383/11/11/3202 |
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