Lee Joon-Hyop, Kim Suhyun, Kim Kwangsoo, Chai Young Jun, Yu Hyeong Won, Kim Su-Jin, Choi June Young, Chung Yoo Seung, Lee Kyu Eun, Yi Ka Hee
Gil Medical Center, Department of Surgery, Gachon University College of Medicine, Incheon 21565, Korea.
Department of Applied Statistics, Chung-Ang University, Seoul 06974, Korea.
J Clin Med. 2021 Sep 28;10(19):4454. doi: 10.3390/jcm10194454.
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.
甲状腺切除术后甲状旁腺功能减退可能导致各种短暂或永久性症状,从刺痛感至严重呼吸困难不等。其发生率在不同外科医生和机构之间有所差异,因此难以确定其实际发生率及相关因素。本研究试图估算两家采用共同数据模型(观察性健康数据科学与信息学)的三级医疗机构中患者术后甲状旁腺功能减退的发生率。本研究使用共同数据模型,通过标准化词汇表来提取明确指定的编码及概念之间的关系。2013年1月至2018年12月期间,从两家不同的三级医院提取了各种甲状腺疾病和甲状腺手术的电子数据交换(EDI)编码。将患者分为无甲状旁腺功能减退证据/短暂性/永久性甲状旁腺功能减退组,以分析与手术类型和诊断相关的甲状旁腺功能减退发生的可能性。在两家机构接受甲状腺切除术的4848例符合条件的患者中,1370例(28.26%)出现短暂性甲状旁腺功能减退,251例(5.18%)出现持续性甲状旁腺功能减退。单因素逻辑回归分析预测,相对于全双侧甲状腺切除术,根治性肿瘤切除术发生短暂性甲状旁腺功能减退的可能性高48%,发生持续性甲状旁腺功能减退的可能性高102%。此外,多因素逻辑分析发现,与全双侧甲状腺切除术相比,根治性肿瘤切除术发生短暂性甲状旁腺功能减退的可能性高50%,发生持续性甲状旁腺功能减退的可能性高97%。通过整合和分析两个数据库得出的这些结果表明,该分析可以扩展至纳入其他采用相同观察性健康数据科学与信息学协议的大型数据库。