Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease
Abstract: Graves' disease (GD) can be surgically treated and present complications like postoperative hypocalcemia. Objectives: (1) Evaluate the incidence of postoperative hypocalcemia in patients with GD. (2) Find out if hypocalcemia incidence is grater in thyroidectomized patie...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/34932 |
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I10-R327-article-34932 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
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R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
hyperthyroidism thyroidectomy hypocalcemias hypovitaminosis D hipertiroidismo tiroidectomía hipocalcemia hipovitaminosis D |
| spellingShingle |
hyperthyroidism thyroidectomy hypocalcemias hypovitaminosis D hipertiroidismo tiroidectomía hipocalcemia hipovitaminosis D Berardo, B Racca, P Delgado Martin, E Geres , A Mereshian , P Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease |
| topic_facet |
hyperthyroidism thyroidectomy hypocalcemias hypovitaminosis D hipertiroidismo tiroidectomía hipocalcemia hipovitaminosis D |
| author |
Berardo, B Racca, P Delgado Martin, E Geres , A Mereshian , P |
| author_facet |
Berardo, B Racca, P Delgado Martin, E Geres , A Mereshian , P |
| author_sort |
Berardo, B |
| title |
Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease |
| title_short |
Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease |
| title_full |
Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease |
| title_fullStr |
Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease |
| title_full_unstemmed |
Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease |
| title_sort |
hypocalcemia as a post-thyroidectomy complication in patients with graves' disease |
| description |
Abstract:
Graves' disease (GD) can be surgically treated and present complications like postoperative hypocalcemia.
Objectives: (1) Evaluate the incidence of postoperative hypocalcemia in patients with GD. (2) Find out if hypocalcemia incidence is grater in thyroidectomized patients due to other causes. (3) Determine whether hypovitaminosis D is predictive of hypocalcemia. (4) Establish the usefulness of vitamin D (VD) substitution.
We conducted an analytic longitudinal observational cohort study. We included 12 patients with GD (Graves group) and 23 thyroidectomized patients as a result of other benign thyroid diseases (BTD), both sexes, 18 to 70 years old. There was a total of 3 males (9%) and 32 females (91%). Preoperative calcemia was (: 9.1 ± 0.5 mg/dL). Postoperative calcemia was (: 8.6 ± 0.6 mg/dL) after 8 hours, (: 8.6 ± 0.6 mg/dL) after 12 hours, (: 8.9 ± 0.6 mg/dL) after 1 month and (: 9 ± 0.8 mg/dL) 6 months after surgery. Preoperative VD was (: 23.1 ± 10 ng/mL).
Hypocalcemia was defined as calcemia < 8.5 mg/dL. Transient calcemia was defined as less than 6 months. Permanent calcemia was defined as over 6 months.
Within GD group, hypocalcemia incidence was 54.4% (6 patients) 8 hours after surgery, 45.5% (4 patients) 12 hours after surgery, 16.7% (2 patients) 1 month after surgery and 33% (4 patients) 6 months after surgery. Within BTD group, hypocalcemia incidence was 26.1% (6 patients) 8 hours after surgery, 26.1% (6 patients) 12 hours after surgery, 13% (3 patients) 1 month after surgery and 22% (5 patients) 6 months after surgery (p>0.05). Preoperative VD in Graves group vs. BTD group (15.3 ± 4.5 ng/dl vs. 25.3 ± 10 ng/dl) (p<0.05). With preoperative VD replacement, we observed that 70% of the patients (n:7) didn't present postoperative hypocalcemia, while 30% (n:3) did. Without preoperative replacement, we observed that 40% of them (n:10) didn't present hypocalcemia, while 60% (n:15) did. (p>0.05).
We noticed that patients with GD have a higher incidence of transient and permanent hypocalcemia than patients in the BTD group. Also, none within the GD group had enough preoperative VD; therefore, hypovitaminosis D might be a predictive factor for hypocalcemia. Although a larger sample is needed, considering sufficient preoperative VD levels would be advisable to avoid postoperative hypocalcemias.
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| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/34932 |
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2024-09-03T21:02:48Z |
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2024-09-03T21:02:48Z |
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I10-R327-article-349322024-04-15T16:19:09Z Hypocalcemia as a post-thyroidectomy complication in patients with Graves' disease Hipocalcemia como complicación post tiroidectomía en pacientes con enfermedad de Graves A Berardo, B Racca, P Delgado Martin, E Geres , A Mereshian , P hyperthyroidism thyroidectomy hypocalcemias hypovitaminosis D hipertiroidismo tiroidectomía hipocalcemia hipovitaminosis D Abstract: Graves' disease (GD) can be surgically treated and present complications like postoperative hypocalcemia. Objectives: (1) Evaluate the incidence of postoperative hypocalcemia in patients with GD. (2) Find out if hypocalcemia incidence is grater in thyroidectomized patients due to other causes. (3) Determine whether hypovitaminosis D is predictive of hypocalcemia. (4) Establish the usefulness of vitamin D (VD) substitution. We conducted an analytic longitudinal observational cohort study. We included 12 patients with GD (Graves group) and 23 thyroidectomized patients as a result of other benign thyroid diseases (BTD), both sexes, 18 to 70 years old. There was a total of 3 males (9%) and 32 females (91%). Preoperative calcemia was (: 9.1 ± 0.5 mg/dL). Postoperative calcemia was (: 8.6 ± 0.6 mg/dL) after 8 hours, (: 8.6 ± 0.6 mg/dL) after 12 hours, (: 8.9 ± 0.6 mg/dL) after 1 month and (: 9 ± 0.8 mg/dL) 6 months after surgery. Preoperative VD was (: 23.1 ± 10 ng/mL). Hypocalcemia was defined as calcemia < 8.5 mg/dL. Transient calcemia was defined as less than 6 months. Permanent calcemia was defined as over 6 months. Within GD group, hypocalcemia incidence was 54.4% (6 patients) 8 hours after surgery, 45.5% (4 patients) 12 hours after surgery, 16.7% (2 patients) 1 month after surgery and 33% (4 patients) 6 months after surgery. Within BTD group, hypocalcemia incidence was 26.1% (6 patients) 8 hours after surgery, 26.1% (6 patients) 12 hours after surgery, 13% (3 patients) 1 month after surgery and 22% (5 patients) 6 months after surgery (p>0.05). Preoperative VD in Graves group vs. BTD group (15.3 ± 4.5 ng/dl vs. 25.3 ± 10 ng/dl) (p<0.05). With preoperative VD replacement, we observed that 70% of the patients (n:7) didn't present postoperative hypocalcemia, while 30% (n:3) did. Without preoperative replacement, we observed that 40% of them (n:10) didn't present hypocalcemia, while 60% (n:15) did. (p>0.05). We noticed that patients with GD have a higher incidence of transient and permanent hypocalcemia than patients in the BTD group. Also, none within the GD group had enough preoperative VD; therefore, hypovitaminosis D might be a predictive factor for hypocalcemia. Although a larger sample is needed, considering sufficient preoperative VD levels would be advisable to avoid postoperative hypocalcemias. Resumen: La enfermedad de Graves (EG) puede ser tratada quirúrgicamente y presentar complicaciones como hipocalcemia postquirúrgica. Objetivos: 1-Evaluar incidencia de hipocalcemia post quirúrgica en pacientes con EG. 2-Conocer si la incidencia de hipocalcemia es mayor que en pacientes con tiroidectomías por otras causas. 3-Determinar si hipovitaminosis D es predictiva para hipocalcemias. 4-Establecer la utilidad de sustituir vitamina D (VD). Realizamos estudio observacional analítico longitudinal de cohorte. Incluimos 12 pacientes con EG (grupo Graves) y 23 tiroidectomizados por otras patologías tiroideas benignas (PTB), ambos sexos, 18-70 años. Total 3 masculinos (9%) y 32 femeninos (91%). Calcemia pre (x-: 9,1 ± 0,5 mg/dl) y post quirúrgica: 8 horas (x-: 8,6 ± 0,6 mg/dl), 12 horas (x-: 8,6 ± 0,6 mg/dl), al mes (x-: 8,9 ± 0,6 mg/dl) y 6 meses (x-: 9 ± 0.8 mg/dl) y VD prequirúrgica (x-: 23,1 ± 10 ng/ml). Definimos hipocalcemia: calcemia < 8,5 mg/dL. Transitoria: menor 6 meses. Permanente: más de 6 meses. En grupo EG, la incidencia de hipocalcemia: a las 8 horas post cirugía 54,4% (6 pacientes), 12 horas 45,5% (4 pacientes), al mes 16,7% (2 pacientes) y a 6 meses 33% (4 pacientes). En grupo PTB, hipocalcemia: 8 horas postquirúrgica 26,1% (6 pacientes), 12 horas 26,1% (6 pacientes), al mes 13% (3 pacientes) y a los 6 meses 22% (5 pacientes) (p>0,05). La VD prequirúrgica en grupo Graves vs. PTB (15,3 ± 4,5 ng/dl vs. 25,3 ± 10 ng/dl) (p<0,05). Con sustitución prequirúrgica de VD observamos que el 70% de los pacientes (n:7) no presentaron hipocalcemia postquirúrgica, y si la presentó el 30% (n:3). En grupo sin sustitución prequirúrgica, no presentaron hipocalcemia el 40% (n:10), aunque sí lo hicieron el 60% (n:15) (p>0.05). Observamos que pacientes con EG tienen mayor incidencia de hipocalcemia transitoria y permanente que el grupo PTB. A su vez, dentro del grupo EG, ninguno tuvo VD suficiente prequirúrgica, por lo que hipovitaminosis D podría ser un factor predictivo para hipocalcemia. Aunque se requiere mayor tamaño en la muestra, sería aconsejable niveles de VD suficientes prequirúrgicos para evitar hipocalcemias postquirúrgicas. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/34932 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |