How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Postsurgical Follow-up Data
2.3. Definition of Postsurgical Hypoparathyroidism
2.4. Handling of Data and Statistical Analysis
2.5. Ethics Approval and Consent to Participate
3. Results
3.1. Postsurgical Hypocalcaemia—Patient Characteristics
3.2. Postsurgical Hypoparathyroidism—Time Course of Recovery
3.3. Postsurgical Hypoparathyroidism—Predictors for Time to Recovery
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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n (%) Unless Otherwise Stated | All Procedures | Procedures w Postsurgical Hypoparathyroidism (PH) n = 143 |
---|---|---|
n = 1097 | ||
Malignant thyroid condition | 155 (14.1) | 20 (14) |
Central LAD | 67 (6.1) | 22 (16.8) |
Graves’ disease | 86 (7.8) | 16 (11.2) |
Reoperative Surgery | 126 (11.5) | 12 (8.4) |
Thyroidectomy | 505 (46) | 127 (88.8) |
Hemithyroidectomy (HTx) | 515 (46.9) | 2 (1.4) |
Two-staged bilateral HTx | 33 (3.0) | 14 (9.8) |
PTG visualised | ||
0 | 71 (6.5) | 7 (4.9) |
1 | 205 (18.7) | 3 (3.1) |
2 | 390 (35.6) | 22 (15.4) |
3 | 152 (13.9) | 43 (30.1) |
4 | 279 (25.4) | 68 (47.5) |
PTG autograft | ||
0 | 938 (85.5) | 110 (76.9) |
1 | 146 (13.3) | 31 (21.7) |
2 | 12 (1.1) | 2 (1.4) |
4 | 1 (0.1) | 0 |
PTH POD 1, median (IQR) | - | 10.4 (8.1–14.4) |
PTH POD 2, median (IQR) | - | 9.8 (7.6–11.9) |
Calcium POD 1, median (IQR) | - | 2.1 (2.0–2.2) |
Calcium POD 2, median (IQR) | - | 2.0 (1.9–2.1) |
n (%) Unless Otherwise Stated | Recovered ≤ 12 Weeks | Recovered > 12 Weeks | p-Value |
---|---|---|---|
n = 96 | n = 47 | ||
Female gender | 85 (88.5) | 37 (78.7) | 0.136 |
Thyroidectomy | 85 (88.5) | 42 (89.4) | 1 |
Graves’ disease | 14 (14.6) | 2 (4.3) | 0.09 |
Malignant thyroid condition | 13 (13.5) | 7 (14.9) | 0.803 |
Central LND | 15 (15.6) | 9 (19.1) | 0.637 |
Reoperative surgery | 5 (10.6) | 7 (7.3) | 0.53 |
PTG visualised | 0.066 | ||
0 | 5 (5.2) | 2 (4.3) | |
1 | 3 (3.1) | 0 | |
2 | 11 (11.5) | 11 (23.4) | |
3 | 25 (26) | 18 (38.3) | |
4 | 52 (54.2) | 16 (34) | |
PTG autograft | 0.223 | ||
0 | 77 (80.2) | 33 (70.2) | |
1 | 17 (17.7) | 14 (29.8) | |
2 | 2 (2.1) | 0 | |
Immediate calcium substitution | 13 (13.5) | 2 (4.3) | 0.144 |
Symptoms of PH | 55 (57.3) | 26 (55.3) | 0.859 |
PTH POD 1, median (IQR) | 11.0 (7.3–11.6) | 9.1 (9–15.4) | 0.006 |
PTH POD 2, median (IQR) | 10.2 (7.8–13.6) | 8.6 (7.8–12.2) | 0.008 |
Calcium POD 1, median (IQR) | 2.1 (2–1.1) | 2.1 (2–2.2) | 0.544 |
Calcium POD 2, median (IQR) | 2 (1.9–2.1) | 2 (1.9–2.1) | 0.31 |
n (%) Unless Otherwise Stated | Recovered ≤ 24 Weeks | Recovered > 24 Weeks | p-Value |
---|---|---|---|
n = 116 | n = 27 | ||
Female gender | 98 (84.5) | 24 (88.9) | 0.765 |
Thyroidectomy | 104 (89.7) | 23 (85.2) | 0.592 |
Malignant thyroid condition | 16 (13.8) | 4 (14.8) | 1 |
Central LAD | 17 (14.7) | 7 (25.9) | 0.163 |
Graves’ disease | 15 (12.9) | 1 (3.7) | 0.307 |
Reoperative surgery | 8 (6.9) | 4 (14.8) | 0.24 |
PTG visualised | 0.089 | ||
0 | 5 (4.3) | 2 (7.4) | 0.62 |
1 | 3 (2.6) | 0 | 1 |
2 | 15 (12.9) | 7 (25.9) | 0.135 |
3 | 33 (28.4) | 10 (37.0) | 0.485 |
4 | 60 (51.7) | 8 (29.6) | 0.053 |
PTG autograft | 1 | ||
0 | 90 (77.6) | 20 (74.1) | |
1 | 24 (20.7) | 7 (25.9) | |
2 | 2 (1.7) | 0 | |
Immediate calcium substitution | 14 (12.1) | 1 (3.7) | 0.304 |
Symptoms of PH | 68 (58.6) | 13 (48.1) | 0.39 |
PTH POD 1, median (IQR) | 10.8 (8.45–15.1) | 8.8 (7.3–12.7) | 0.033 |
PTH POD 2, median (IQR) | 9.9 (7.78–12.53) | 8.4 (7–10.45) | 0.057 |
PTH > 15 and <65 POD 1 | 48 (42.1) | 7 (25.9) | 0.132 |
PTH ≥ 10 POD 1 | 54 (46.6) | 18 (66.7) | 0.086 |
Calcium POD 1, median (IQR) | 2.1 (2–2.2) | 2.0 (2–2.1) | 0.096 |
Calcium POD 2, median (IQR) | 2 (1.9–2.1) | 1.95 (1.8–2.1) | 0.387 |
Univariable Analysis | Multivariable Analysis | |||||||
---|---|---|---|---|---|---|---|---|
OR | Lower CI | Upper CI | p-Value | OR | Lower CI | Upper CI | p-Value | |
(a) recovery within 4 weeks (within 4 weeks n = 41 vs. later than 4 weeks n = 102) | ||||||||
Graves’ disease | 3.82 | 1.32 | 11.08 | 0.014 | 2.40 | 0.72 | 8.07 | 0.156 |
Central LAD | 0.61 | 0.21 | 1.75 | 0.355 | ||||
All PTG visualized | 1.86 | 0.89 | 3.88 | 0.097 | 2.02 | 0.88 | 4.63 | 0.098 |
PTG autograft | 1.35 | 0.64 | 2.89 | 0.433 | ||||
PTH POD 1 | 1.12 | 1.05 | 1.19 | <0.001 | 1.13 | 1.06 | 1.20 | <0.001 |
Calcium POD 1 | 0.40 | 0.03 | 4.70 | 0.464 | ||||
Symptoms | 1.12 | 0.54 | 2.32 | 0.772 | ||||
Female gender | 2.71 | 0.75 | 9.77 | 0.127 | 2.69 | 0.64 | 11.34 | 0.178 |
HL ChiSq 13.966, p 0.083, AUC 0.771 | ||||||||
(b) recovery within 24 weeks (within 12 weeks n = 116 vs. later than 24 weeks n = 27) | ||||||||
Graves’ disease | 3.86 | 0.49 | 30.3 | 0.201 | ||||
Malignity | 0.92 | 0.28 | 3.01 | 0.890 | ||||
All PTG visualized | 2.55 | 1.03 | 6.29 | 0.043 | 2.69 | 1.08 | 6.69 | 0.033 |
PTG autograft | 0.92 | 0.38 | 2.25 | 0.856 | ||||
PTH POD 1 | 1.07 | 0.98 | 1.16 | 0.136 | 1.07 | 0.98 | 1.16 | 0.125 |
Ca POD 1 | 7.04 | 0.40 | 125.0 | 0.184 | ||||
Symptoms | 0.65 | 0.28 | 1.52 | 0.325 | ||||
Female gender | 0.68 | 0.19 | 2.50 | 0.562 | ||||
HL ChiSq 7.267, p 0.508, AUC 0.664 |
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Guglielmetti, L.; Schmidt, S.; Busch, M.; Wagner, J.; Naddaf, A.; Leitner, B.; Harsch, S.; Zielke, A.; Smaxwil, C. How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis. J. Clin. Med. 2022, 11, 3202. https://doi.org/10.3390/jcm11113202
Guglielmetti L, Schmidt S, Busch M, Wagner J, Naddaf A, Leitner B, Harsch S, Zielke A, Smaxwil C. How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis. Journal of Clinical Medicine. 2022; 11(11):3202. https://doi.org/10.3390/jcm11113202
Chicago/Turabian StyleGuglielmetti, Laura, Sina Schmidt, Mirjam Busch, Joachim Wagner, Ali Naddaf, Barbara Leitner, Simone Harsch, Andreas Zielke, and Constantin Smaxwil. 2022. "How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis" Journal of Clinical Medicine 11, no. 11: 3202. https://doi.org/10.3390/jcm11113202
APA StyleGuglielmetti, L., Schmidt, S., Busch, M., Wagner, J., Naddaf, A., Leitner, B., Harsch, S., Zielke, A., & Smaxwil, C. (2022). How Long Does It Take to Regain Normocalcaemia in the Event of Postsurgical Hypoparathyroidism? A Detailed Time Course Analysis. Journal of Clinical Medicine, 11(11), 3202. https://doi.org/10.3390/jcm11113202