Hypoparathyroidism and mortality after total thyroidectomy : A nationwide matched cohort study
© 2024 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd..
OBJECTIVE: Total thyroidectomy (TT) carries a risk of hypoparathyroidism (hypoPT). Recently, hypoPT has been associated with higher overall mortality rates. We aimed to evaluate the frequency of hypoPT and mortality in patients undergoing TT in Denmark covering 20 years.
DESIGN: Retrospective Cohort study.
PATIENTS AND MEASUREMENTS: Using population-based registries, we identified all Danish individuals who had undergone TT between January 1998 and December 2017. We included a comparison cohort by randomly selecting 10 citizens for each patient, matched on sex and birth year. HypoPT was defined as treatment with active vitamin D after 12 months postoperatively. We used cumulative incidence to calculate risks and Cox regression to compare the rate of mortality between patients and the comparison cohort. We evaluated patients in different comorbidity groups using the Charlson Comorbidity Index and by different indications for surgery.
RESULTS: 7912 patients underwent TT in the period. The prevalence of hypoPT in the study period was 16.6%, 12 months postoperatively. After adjusting for potential confounders the risk of death due to any causes (hazard ratio; 95% confidence intervals) following TT was significantly increased (1.34; 1.15-1.56) for patients who developed hypoPT. However, subgroup analysis revealed mortality was only increased in malignancy cases (2.48; 1.99-3.10) whereas mortality was not increased when surgery was due to benign indications such as goitre (0.88; 0.68-1.15) or thyrotoxicosis (0.86; 0.57-1.28).
CONCLUSIONS: The use of active vitamin D for hypoPT was prevalent one year after TT. Patients with hypoPT did not have an increased risk of mortality following TT unless the indication was due to malignancy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:100 |
|---|---|
| Enthalten in: |
Clinical endocrinology - 100(2024), 4 vom: 19. Apr., Seite 408-415 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Reinke, Rasmus [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
1406-16-2 |
|---|
| Anmerkungen: |
Date Completed 07.03.2024 Date Revised 05.04.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/cen.15037 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368660419 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368660419 | ||
| 003 | DE-627 | ||
| 005 | 20240406232157.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240220s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/cen.15037 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1367.xml |
| 035 | |a (DE-627)NLM368660419 | ||
| 035 | |a (NLM)38375986 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Reinke, Rasmus |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hypoparathyroidism and mortality after total thyroidectomy |b A nationwide matched cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.03.2024 | ||
| 500 | |a Date Revised 05.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: Total thyroidectomy (TT) carries a risk of hypoparathyroidism (hypoPT). Recently, hypoPT has been associated with higher overall mortality rates. We aimed to evaluate the frequency of hypoPT and mortality in patients undergoing TT in Denmark covering 20 years | ||
| 520 | |a DESIGN: Retrospective Cohort study | ||
| 520 | |a PATIENTS AND MEASUREMENTS: Using population-based registries, we identified all Danish individuals who had undergone TT between January 1998 and December 2017. We included a comparison cohort by randomly selecting 10 citizens for each patient, matched on sex and birth year. HypoPT was defined as treatment with active vitamin D after 12 months postoperatively. We used cumulative incidence to calculate risks and Cox regression to compare the rate of mortality between patients and the comparison cohort. We evaluated patients in different comorbidity groups using the Charlson Comorbidity Index and by different indications for surgery | ||
| 520 | |a RESULTS: 7912 patients underwent TT in the period. The prevalence of hypoPT in the study period was 16.6%, 12 months postoperatively. After adjusting for potential confounders the risk of death due to any causes (hazard ratio; 95% confidence intervals) following TT was significantly increased (1.34; 1.15-1.56) for patients who developed hypoPT. However, subgroup analysis revealed mortality was only increased in malignancy cases (2.48; 1.99-3.10) whereas mortality was not increased when surgery was due to benign indications such as goitre (0.88; 0.68-1.15) or thyrotoxicosis (0.86; 0.57-1.28) | ||
| 520 | |a CONCLUSIONS: The use of active vitamin D for hypoPT was prevalent one year after TT. Patients with hypoPT did not have an increased risk of mortality following TT unless the indication was due to malignancy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a hypoparathyroidism | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a thyroid cancer | |
| 650 | 4 | |a thyrotoxicosis | |
| 650 | 4 | |a total thyroidectomy | |
| 650 | 7 | |a Vitamin D |2 NLM | |
| 650 | 7 | |a 1406-16-2 |2 NLM | |
| 700 | 1 | |a Udholm, Sebastian |e verfasserin |4 aut | |
| 700 | 1 | |a Christiansen, Christian Fynbo |e verfasserin |4 aut | |
| 700 | 1 | |a Almquist, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Londero, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Rejnmark, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a Rasmussen, Thomas Bøjer |e verfasserin |4 aut | |
| 700 | 1 | |a Rolighed, Lars |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical endocrinology |d 1972 |g 100(2024), 4 vom: 19. Apr., Seite 408-415 |w (DE-627)NLM000089117 |x 1365-2265 |7 nnns |
| 773 | 1 | 8 | |g volume:100 |g year:2024 |g number:4 |g day:19 |g month:04 |g pages:408-415 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/cen.15037 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 100 |j 2024 |e 4 |b 19 |c 04 |h 408-415 | ||