Abstract
Post-thyroidectomy hypoparathyroidism may result in various transient or permanent symptoms, ranging from tingling sensation to severe breathing difficulties. Its incidence varies among surgeons and institutions, making it difficult to determine its actual incidence and associated factors. This study attempted to estimate the incidence of post-operative hypoparathyroidism in patients at two tertiary institutions that share a common data model, the Observational Health Data Sciences and Informatics. This study used the Common Data Model to extract explicitly specified encoding and relationships among concepts using standardized vocabularies. The EDI-codes of various thyroid disorders and thyroid operations were extracted from two separate tertiary hospitals between January 2013 and December 2018. Patients were grouped into no evidence of/transient/permanent hypoparathyroidism groups to analyze the likelihood of hypoparathyroidism occurrence related to operation types and diagnosis. Of the 4848 eligible patients at the two institutions who underwent thyroidectomy, 1370 (28.26%) experienced transient hypoparathyroidism and 251 (5.18%) experienced persistent hypoparathyroidism. Univariate logistic regression analysis predicted that, relative to total bilateral thyroidectomy, radical tumor resection was associated with a 48% greater likelihood of transient hypoparathyroidism and a 102% greater likelihood of persistent hypoparathyroidism. Moreover, multivariate logistic analysis found that radical tumor resection was associated with a 50% greater likelihood of transient hypoparathyroidism and a 97% greater likelihood of persistent hypoparathyroidism than total bilateral thyroidectomy. These findings, by integrating and analyzing two databases, suggest that this analysis could be expanded to include other large databases that share the same Observational Health Data Sciences and Informatics protocol.
Highlights
Post-thyroidectomy hypoparathyroidism is an unintended sequela that may result in transient or permanent symptoms ranging from tingling sensation to severe breathing difficulties if left untreated [1]
The present study evaluated the incidence of hypoparathyroidism among 4848 eligible patients who underwent thyroid surgery at two tertiary centers
Univariate analysis identified meaningful baseline factors associated with hypoparathyroidism, whereas multivariate analysis failed to identify statistically significant factors
Summary
Post-thyroidectomy hypoparathyroidism is an unintended sequela that may result in transient or permanent symptoms ranging from tingling sensation to severe breathing difficulties if left untreated [1]. The incidence of iatrogenic hypoparathyroidism has been reported to range from 7% to 37% [2,3], a range too broad to be indicative. This variability in incidence stems from inter-operator variability, and from differences in thyroid operations performed in various medical communities. Because medical services in South Korea are readily accessible to the general population, thyroid cancer tends to be detected at an early stage and its incidence is very high, about 51.1 per 100,000 persons in 2017 [4]. About 68.5% of operations for thyroid cancer in 2019 were performed by a high volume surgeons at tertiary medical centers due to the high density and urban orientation of the population of South Korea [5]
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