Predictors of hypocalcemia after thyroidectomy: results from the nationwide inpatient sample.

ISRN surgery Pub Date : 2012-01-01 Epub Date: 2012-07-15 DOI:10.5402/2012/838614
Randall L Baldassarre, David C Chang, Kevin T Brumund, Michael Bouvet
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引用次数: 82

Abstract

Hypocalcemia is a common complication following thyroidectomy. However, the incidence of postoperative hypocalcemia varies widely in the literature, and factors associated with hypocalcemia after thyroid surgery are not well established. We aimed to identify incidence trends and independent risk factors of postoperative hypocalcemia using the nationwide inpatient sample (NIS) database from 1998 to 2008. Overall, 6,605 (5.5%) of 119,567 patients who underwent thyroidectomy developed hypocalcemia. Total thyroidectomy resulted in a significantly higher increased incidence (9.0%) of hypocalcemia when compared with unilateral thyroid lobectomy (1.9%; P < .001). Thyroidectomy with bilateral neck dissection, the strongest independent risk factor of postoperative hypocalcemia (odds ratio, 9.42; P < .001), resulted in an incidence of 23.4%. Patients aged 45 years to 84 years were less likely to have postoperative hypocalcemia compared with their younger and older counterparts (P < .001). Hispanic (P = .003) and Asian (P = .027) patients were more likely, and black patients were less likely (P = .003) than white patients to develop hypocalcemia. Additional factors independently associated with postoperative hypocalcemia included female gender, nonteaching hospitals, and malignant neoplasms of thyroid gland. Hypocalcemia following thyroidectomy resulted in 1.47 days of extended hospital stay (3.33 versus 1.85 days P < .001).

Abstract Image

甲状腺切除术后低钙血症的预测因素:来自全国住院患者样本的结果。
低钙血症是甲状腺切除术后常见的并发症。然而,文献中关于术后低血钙的发生率差异很大,甲状腺手术后低血钙的相关因素也没有很好的确定。我们旨在利用1998年至2008年的全国住院患者样本(NIS)数据库确定术后低钙血症的发病率趋势和独立危险因素。总体而言,119,567例接受甲状腺切除术的患者中,有6,605例(5.5%)发生了低钙血症。与单侧甲状腺叶切除术相比,全甲状腺切除术导致低钙血症发生率(9.0%)显著增加(1.9%;P < 0.001)。甲状腺切除术合并双侧颈部清扫是术后低血钙的最强独立危险因素(优势比,9.42;P < 0.001),发生率为23.4%。45岁至84岁的患者术后发生低钙血症的可能性低于年轻和年长的患者(P < 0.001)。西班牙裔(P = 0.003)和亚洲(P = 0.027)患者发生低钙血症的可能性更大,黑人患者发生低钙血症的可能性更小(P = 0.003)。与术后低血钙独立相关的其他因素包括女性、非教学医院和甲状腺恶性肿瘤。甲状腺切除术后低钙导致住院时间延长1.47天(3.33天对1.85天,P < 0.001)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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