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Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults.
Endocrine ( IF 3.7 ) Pub Date : 2021-08-04 , DOI: 10.1007/s12020-021-02840-9 María Paz Barbier 1 , Evelin Mingote 1 , Noelia Sforza 1 , Yanina Morosán Allo 1 , Maximiliano Lotartaro 2 , Leonardo Serrano 2 , María Pía Fossati 3 , Tomas Meroño 4, 5 , Cristina Faingold 1 , Claudia Sedlinsky 1 , Gabriela Brenta 1
Endocrine ( IF 3.7 ) Pub Date : 2021-08-04 , DOI: 10.1007/s12020-021-02840-9 María Paz Barbier 1 , Evelin Mingote 1 , Noelia Sforza 1 , Yanina Morosán Allo 1 , Maximiliano Lotartaro 2 , Leonardo Serrano 2 , María Pía Fossati 3 , Tomas Meroño 4, 5 , Cristina Faingold 1 , Claudia Sedlinsky 1 , Gabriela Brenta 1
Affiliation
PURPOSE
Transient hypocalcaemia after thyroid surgery and its possible predictors have not been extensively described in the elderly. This study aimed to establish the frequency of postsurgical transient hypocalcaemia according to the extent of thyroid surgery in older adults and to assess mineral metabolism biochemical parameters as its predictors.
METHODS
All patients ≥60 years undergoing thyroid surgery were prospectively included. Type of surgery (hemithyroidectomy(HT) or total thyroidectomy(TT)); and preoperative 25OH Vitamin D (25OHD) and pre and 6 (only TT), 24 h and 6 months postsurgical serum levels of calcium, magnesium, phosphate and parathormone (PTH) were considered. Postsurgical hypoparathyroidism (hPTpost) was defined at PTH levels ≤11 pg/mL.
RESULTS
Out of 46 patients (87% female), age (mean ± SD) 70.1 ± 6.2 years, 24 h postsurgical hypocalcaemia was found in ten patients (22%). In 25 (54%) TT patients, 36% and 16% had postsurgical hypocalcaemia at 6 and 24 h respectively; 28% hPTpost but no definitive hPT was recorded and 44% had 25OHD deficiency. Lower 24 h magnesium levels were found in those TT patients with 24 h hypocalcaemia (1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005)). Among 21 (46%) HT patients, 28.6% had 24 h postsurgical hypocalcaemia; 9.5% had hPTpost. A positive correlation was observed between preoperative 25OHD and 24 h calcaemia (r:0.51,p = 0.02). 43% of the patients were 25OHD deficient, in whom 55% had 24 h hypocalcaemia vs only 9% in the 25OHD sufficient group (p = 0.049).
CONCLUSION
Postsurgical hypocalcaemia was common in elderly thyroidectomized patients. After TT, lower magnesium levels were found in those patients with 24 h hypocalcaemia. In the HT group, preoperative 25OHD deficiency predicted lower postsurgical calcium levels.
中文翻译:
老年人甲状腺手术类型不同的术后低钙血症的发生率和预测因素。
目的 甲状腺手术后的短暂性低钙血症及其可能的预测因素尚未在老年人中得到广泛描述。本研究旨在根据老年人甲状腺手术的程度确定术后短暂性低钙血症的频率,并评估矿物质代谢生化参数作为其预测指标。方法 前瞻性纳入所有≥60 岁接受甲状腺手术的患者。手术类型(半甲状腺切除术(HT)或全甲状腺切除术(TT));并考虑了术前25OH维生素D(25OHD)和术前和6(仅TT)、术后24小时和6个月的血清钙、镁、磷酸盐和甲状旁腺素(PTH)水平。术后甲状旁腺功能减退症 (hPTpost) 定义为 PTH 水平≤11 pg/mL。结果 在 46 名患者中(87% 为女性),年龄(平均值 ± SD)70.1 ± 6.2 岁,在 10 名患者 (22%) 中发现了术后 24 小时低钙血症。在 25 名 (54%) TT 患者中,36% 和 16% 分别在 6 小时和 24 小时出现术后低钙血症;28% hPTpost 但未记录明确的 hPT,44% 有 25OHD 缺乏。在 24 小时低钙血症的 TT 患者中发现较低的 24 小时镁水平(1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005))。在 21 名 (46%) HT 患者中,28.6% 的患者术后 24 小时出现低钙血症;9.5% 有 hPTpost。术前25OHD与24 h血钙呈正相关(r:0.51,p = 0.02)。43% 的患者 25OHD 缺乏,其中 55% 有 24 小时低钙血症,而 25OHD 充足组只有 9% (p = 0.049)。结论 老年甲状腺切除患者术后低钙血症较为常见。TT之后,在 24 小时低钙血症患者中发现较低的镁水平。在 HT 组中,术前 25OHD 缺乏预示着术后钙水平较低。
更新日期:2021-08-04
中文翻译:
老年人甲状腺手术类型不同的术后低钙血症的发生率和预测因素。
目的 甲状腺手术后的短暂性低钙血症及其可能的预测因素尚未在老年人中得到广泛描述。本研究旨在根据老年人甲状腺手术的程度确定术后短暂性低钙血症的频率,并评估矿物质代谢生化参数作为其预测指标。方法 前瞻性纳入所有≥60 岁接受甲状腺手术的患者。手术类型(半甲状腺切除术(HT)或全甲状腺切除术(TT));并考虑了术前25OH维生素D(25OHD)和术前和6(仅TT)、术后24小时和6个月的血清钙、镁、磷酸盐和甲状旁腺素(PTH)水平。术后甲状旁腺功能减退症 (hPTpost) 定义为 PTH 水平≤11 pg/mL。结果 在 46 名患者中(87% 为女性),年龄(平均值 ± SD)70.1 ± 6.2 岁,在 10 名患者 (22%) 中发现了术后 24 小时低钙血症。在 25 名 (54%) TT 患者中,36% 和 16% 分别在 6 小时和 24 小时出现术后低钙血症;28% hPTpost 但未记录明确的 hPT,44% 有 25OHD 缺乏。在 24 小时低钙血症的 TT 患者中发现较低的 24 小时镁水平(1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005))。在 21 名 (46%) HT 患者中,28.6% 的患者术后 24 小时出现低钙血症;9.5% 有 hPTpost。术前25OHD与24 h血钙呈正相关(r:0.51,p = 0.02)。43% 的患者 25OHD 缺乏,其中 55% 有 24 小时低钙血症,而 25OHD 充足组只有 9% (p = 0.049)。结论 老年甲状腺切除患者术后低钙血症较为常见。TT之后,在 24 小时低钙血症患者中发现较低的镁水平。在 HT 组中,术前 25OHD 缺乏预示着术后钙水平较低。