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Multicenter Study
. 2019 Nov;66(2):405-415.
doi: 10.1007/s12020-019-02014-8. Epub 2019 Jul 17.

Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis

Juan J Díez  1   2 , Emma Anda  3 , Julia Sastre  4 , Begoña Pérez Corral  5 , Cristina Álvarez-Escolá  6 , Laura Manjón  7 , Miguel Paja  8 , Marcel Sambo  9 , Piedad Santiago Fernández  10 , Concepción Blanco Carrera  11 , Juan C Galofré  12 , Elena Navarro  13 , Carles Zafón  14 , Eva Sanz  14 , Amelia Oleaga  8 , Orosia Bandrés  15 , Sergio Donnay  16 , Ana Megía  17 , María Picallo  9 , Cecilia Sánchez Ragnarsson  7 , Gloria Baena-Nieto  18 , José Carlos Fernández García  19 , Beatriz Lecumberri  6 , Manel Sahún de la Vega  20 , Ana R Romero-Lluch  13 , Pedro Iglesias  21   22
Affiliations
Multicenter Study

Prevalence and risk factors for hypoparathyroidism following total thyroidectomy in Spain: a multicentric and nation-wide retrospective analysis

Juan J Díez et al. Endocrine. 2019 Nov.

Erratum in

Abstract

Purpose: The prevalence of postoperative hypoparathyroidism has been studied in registries and in surgical series with highly variable and imprecise results. However, the frequency of this hormonal deficiency in the clinical practice of endocrinologists is not known with accuracy. We aimed to assess the prevalence and risk factors of hypoparathyroidism in patients undergoing total thyroidectomy in Spain.

Methods: We designed a retrospective, multicentre and nation-wide protocol including all patients with total thyroidectomy who were seen in the endocrinology clinic of the participant centers from January to March 2018. Prevalence of hypoparathyroidism was evaluated at discharge of surgery, 3-6 months after surgery, 12 months after surgery and at last visit. Twenty hospitals participated in the study.

Results: Of 1792 patients undergoing total thyroidectomy, 866 (48.3%) developed postoperative hypoparathyroidism at discharge of surgery. Most of them recover parathyroid function over time. Prevalence of hypoparathyroidism at 3-6 months, 12 months and at last visit was 22.9%, 16.7% and 14.5%, respectively. The risk of developing definitive hypoparathyroidism was related to the presence of parathyroid tissue at histology, lymph node dissection, and two-stage thyroidectomy. Patients with thyroid cancer, with higher postoperative calcium levels and treated by expert surgical teams exhibited lower risk of developing permanent hypoparathyroidism.

Conclusions: Although most patients with postsurgical hypoparathyroidism recover parathyroid function, the prevalence of permanent disease in clinical practice is non negligible (14.5%). Postoperative calcium, extent and timing of surgery, the presence of cancer, expert surgical team, and parathyroid tissue at histology are predictors of permanent hypoparathyroidism.

Keywords: Hypocalcemia; Hypoparathyroidism; Prevalence; Risk factors; Thyroid surgery; Thyroidectomy.

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