Risk Factors for Hypoparathyroidism Following Thyroidectomy

Tartu University Hospital300 enrolled

Overview

The goal of this observational study is to identify the risk factors for post-thyroidectomy hypoparathyroidism in Estonia and to determine whether the magnesium level plays a significant role in the development of hypoparathyroidism. The main questions it aims to answer are: * How common is post-thyroidectomy hypoparathyroidism in Estonia? * What are the most significant risk factors for the development of post-thyroidectomy hypoparathyroidism in Estonia? * Are magnesium levels a risk factor for the development of hypoparathyroidism? Participants will be asked to answer a questionnaire about risk factors. The study collects data on risk factors for hypoparathyroidism following thyroid surgery, including patient questionnaires and comorbidities, pre- and postoperative laboratory tests and surgery-related risk factors.

Study Type

OBSERVATIONAL

Enrollment

300

Conditions

Post-Surgical Hypoparathyroidism

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients over the age of 18 undergoing surgery involving both lobes of the thyroid gland (thyroidectomy, "near-total" thyroidectomy, subtotal thyroidectomy, and "completed" thyroidectomy) * patients who are capable of giving informed consent Exclusion Criteria: * patients undergoing unilateral thyroid lobectomy only * patients with concomitant hyperparathyroidism undergoing simultaneous thyroidectomy and parathyroidectomy for a parathyroid adenoma

Locations (2)

Outcomes

Primary Outcomes

postoperative early hypoparathyroidism

Incidence of early post-thyroidectomy hypoparathyroidism, based on serum PTH levels measured on the morning of the first postoperative day

Time frame: first postoperative day

Secondary Outcomes

Risk factor assessment of post-thyroidectomy hypoparathyroidism

Risk factors will be categorized as patient-related, disease-related, and surgery-related variables. Risk factors will be assessed using multivariable logistic regression analysis, and results will be reported as odds ratios with 95% confidence intervals. Patient-related risk factors will be assessed using a structured study-specific questionnaire (including demographic and clinical history variables) and review of electronic medical records. Disease-related risk factors will be assessed using also preoperative laboratory measurements. Surgery-related risk factors will be assessed using standardized operative reports, including variables such as extent of thyroidectomy, identification and preservation of parathyroid glands, and intraoperative findings, recorded according to institutional surgical protocols. Patient- and disease-related variables will be assessed preoperatively, while surgery-related variables will be assessed intraoperatively.

Time frame: Preoperative and intraoperative periods

Serum magnesium levels as predictors of post-thyroidectomy hypoparathyroidism

Serum magnesium levels will be measured preoperatively (baseline, prior to surgery) and on postoperative day 1. The predictive value of preoperative and postoperative day 1 serum magnesium levels for early post-thyroidectomy hypoparathyroidism will be assessed using univariable and multivariable logistic regression analysis, with results reported as odds ratios and 95% confidence intervals.

Time frame: Preoperative (baseline) and postoperative day 1; hypoparathyroidism assessed within 24 hours postoperatively

Postoperative permanent hypoparathyroidism

Incidence of permanent post-thyroidectomy hypoparathyroidism, defined as persistently low serum PTH levels and/or ongoing requirement for calcium and/or vitamin D supplementation at 12 months after surgery.

Time frame: 12 months after surgery