Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Case Western Reserve University School of Medicine, Cleveland, OH, USA; Department of Otolaryngology - Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Am J Otolaryngol. 2024 May-Jun;45(3):104239. doi: 10.1016/j.amjoto.2024.104239. Epub 2024 Feb 28.
Hypothyroidism is a known possibility after hemithyroidectomy, with a highly variable incidence in the literature ranging from 8 to 60 %. Incidence of hypothyroidism after hemithyroidectomy was evaluated with a secondary aim to assess incidence in patients with Hashimoto's disease.
MATERIALS & METHODS: A retrospective study using the TriNetX global federated research network was performed. We included patients within the last 15 years that were ≥18 years of age and had Current Procedural Terminology codes for hemithyroidectomy. Patients were excluded if they had a total or completion thyroidectomy at any time, a history of thyroid cancer, were preoperatively either on levothyroxine, diagnosed with hypothyroidism, or had a Thyroid Stimulating Hormone ≥ 4 m[IU]/L. We assessed the 3 month incidence of hypothyroidism postoperatively based on the International Classification of Diseases code, TSH ≥ 4 m[IU]/L, or taking levothyroxine after surgery.
6845 patients met the inclusion criteria. Most of the cohort was female (67 %) and white (63 %). The mean age at surgery for this population was 54 ± 14.8 years. During the 15 years of data, we found the 3-month incidence of hypothyroidism following hemithyroidectomy to be 23.58 %. The median time to develop the disease was 41.8 months. A subgroup analysis of those with Hashimoto's revealed a 3-month incidence of 31.1 % of patients developing hypothyroidism after surgery.
This population-based study gives additional insight into the incidence of hypothyroidism after hemithyroidectomy. This will help improve perioperative patient counseling and management.
甲状腺次全切除术后发生甲状腺功能减退症是已知的可能性，文献中的发病率差异很大，范围为 8%至 60%。本研究旨在评估甲状腺次全切除术后甲状腺功能减退症的发生率，并评估桥本甲状腺炎患者的发病率。
使用 TriNetX 全球联合研究网络进行回顾性研究。我们纳入了过去 15 年内年龄≥18 岁且有甲状腺次全切除术的患者。如果患者在任何时候行甲状腺全切除术或甲状腺切除术、有甲状腺癌病史、术前使用左甲状腺素、被诊断为甲状腺功能减退症或促甲状腺激素≥4mIU/L，则排除在外。我们根据国际疾病分类代码、促甲状腺激素≥4mIU/L 或术后服用左甲状腺素来评估术后 3 个月甲状腺功能减退症的发生率。
6845 例患者符合纳入标准。该队列的大多数为女性（67%）和白人（63%）。该人群的平均手术年龄为 54±14.8 岁。在 15 年的数据中，我们发现甲状腺次全切除术后 3 个月甲状腺功能减退症的发生率为 23.58%。发生疾病的中位时间为 41.8 个月。对桥本甲状腺炎患者的亚组分析显示，术后 3 个月有 31.1%的患者发生甲状腺功能减退症。
这项基于人群的研究提供了甲状腺次全切除术后甲状腺功能减退症发生率的更多信息。这将有助于改善围手术期患者咨询和管理。
