Background

Postoperative hypoparathyroidism (PH) is the most common complication after total thyroidectomy. Incidence varies from 2% to 83%, depending on the definition.

Objective

We performed a systematic review of the literature to determine the medico-economic effects of PH and update understanding of long-term consequences, morbidity, and quality of life related to hypoparathyroidism.

Methods

We considered relevant articles published between 2000 and 2020 concerning long-term consequences of PH and quality of life. All studies concerning the medico-economic assessment of PH were included. We compared data from 2018 to results in the literature.

Results

A proportion of 64/403 (16.8%) patients presented with transient PH during 2018, and 7/403 (1.7%) had permanent PH. Seven patients needed supplementation with alfacalcidol at 6-month follow-up. Factors predicting the need for alfacalcidol were age <45, thyroidectomy for goiter, and lymph node dissection. Additional therapy costs related to PH were €9781.10, and additional hospital costs were €230,400. We qualitatively synthesized 41 studies. Most were retrospective studies and only a few reported costs. No series assessed direct or indirect costs of postoperative PH.

Conclusion

To our knowledge, no previous studies reported the medico-economic impact of PH. Decreasing PH associated with fluorescence usage should be considered, particularly concerning cost-effectiveness.

中文翻译：

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甲状旁腺功能减退症：后果、经济影响和前景。案例系列和系统评价

背景

术后甲状旁腺功能减退症（PH）是甲状腺全切除术后最常见的并发症。根据定义，发病率从 2% 到 83% 不等。

客观的

我们对文献进行了系统回顾，以确定 PH 的医学经济影响，并更新对与甲状旁腺功能减退相关的长期后果、发病率和生活质量的理解。

方法

我们考虑了 2000 年至 2020 年间发表的有关 PH 的长期后果和生活质量的相关文章。所有关于 PH 的医学经济评估的研究都包括在内。我们将 2018 年的数据与文献中的结果进行了比较。

结果

2018 年有 64/403 (16.8%) 名患者出现一过性 PH，7/403 (1.7%) 患有永久性 PH。在 6 个月的随访中，7 名患者需要补充阿法骨化醇。预测需要使用阿法骨化醇的因素是年龄<45、甲状腺肿大的甲状腺切除术和淋巴结清扫术。与 PH 相关的额外治疗费用为 9781.10 欧元，额外的医院费用为 230,400 欧元。我们定性地综合了 41 项研究。大多数是回顾性研究，只有少数报告了成本。没有系列评估术后 PH 的直接或间接成本。

结论

据我们所知，以前没有研究报告过 PH 对医学经济的影响。应考虑降低与荧光使用相关的 PH，特别是在成本效益方面。