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Article: Clinicopathologic predictors for early and late biochemical hypothyroidism after hemithyroidectomy

TitleClinicopathologic predictors for early and late biochemical hypothyroidism after hemithyroidectomy
Authors
KeywordsHemithyroidectomy
Hypothyroidism
Surgical outcome
Thyroid cancer
Thyroidectomy
Thyroiditis
Issue Date2012
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurg
Citation
The American Journal of Surgery, 2012, v. 203 n. 4, p. 461-466 How to Cite?
AbstractBackground: Biochemical hypothyroidism (BH) after hemithyroidectomy is an under-recognized complication with a reported incidence of 9% to 43%. This study aimed to identify potential clinicopathologic risk factors associated with early (<12 months after hemithyroidectomy) and late-onset (≥12 months after hemithyroidectomy) BH. Methods: From 2005 to 2008 there were 263 postsurgical patients who were eligible for analysis. Serum thyroid stimulating hormone (TSH) level was checked regularly after surgery. Postoperative TSH reaching a level higher than 5.5 mIU/L was defined as BH. The overall median follow-up period was 21 months (range, 362 mo). Any clinicopathologic factors significantly associated with BH in the univariate analysis were entered into multivariate analysis. A further analysis was performed comparing factors between early and late-onset BH. Results: There were 38 patients who developed subsequent BH, 33 of these cases developed within 2 years. Those patients with BH were significantly older (P =.037), had a higher preoperative TSH level (P <.001), longer follow-up period (P <.001), more frequent thyroiditis on histology (P =.043), lighter resected tissue weight (P =.001), and were more likely to have positive antimicrosomal antibodies (P =.043) than those without BH. However, in the multivariate analysis after adjusting for different follow-up periods in the 2 groups, only lighter resected tissue weight (P =.036) and concomitant thyroiditis on histology (P =.005) turned out to be independent factors for BH. Thyroiditis on histology was also the only significant risk factor for developing early onset BH. Conclusions: Patients with lighter resected tissue weight and concomitant thyroiditis on histology were particularly at risk for subsequent BH. Although not all patients with thyroiditis developed BH, in those who did develop BH it occurred within the first 11 months. © 2012 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/135534
ISSN
2023 Impact Factor: 2.7
2023 SCImago Journal Rankings: 0.897
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChu, KKWen_US
dc.contributor.authorLang, BHHen_US
dc.date.accessioned2011-07-27T01:36:37Z-
dc.date.available2011-07-27T01:36:37Z-
dc.date.issued2012en_US
dc.identifier.citationThe American Journal of Surgery, 2012, v. 203 n. 4, p. 461-466en_US
dc.identifier.issn0002-9610-
dc.identifier.urihttp://hdl.handle.net/10722/135534-
dc.description.abstractBackground: Biochemical hypothyroidism (BH) after hemithyroidectomy is an under-recognized complication with a reported incidence of 9% to 43%. This study aimed to identify potential clinicopathologic risk factors associated with early (<12 months after hemithyroidectomy) and late-onset (≥12 months after hemithyroidectomy) BH. Methods: From 2005 to 2008 there were 263 postsurgical patients who were eligible for analysis. Serum thyroid stimulating hormone (TSH) level was checked regularly after surgery. Postoperative TSH reaching a level higher than 5.5 mIU/L was defined as BH. The overall median follow-up period was 21 months (range, 362 mo). Any clinicopathologic factors significantly associated with BH in the univariate analysis were entered into multivariate analysis. A further analysis was performed comparing factors between early and late-onset BH. Results: There were 38 patients who developed subsequent BH, 33 of these cases developed within 2 years. Those patients with BH were significantly older (P =.037), had a higher preoperative TSH level (P <.001), longer follow-up period (P <.001), more frequent thyroiditis on histology (P =.043), lighter resected tissue weight (P =.001), and were more likely to have positive antimicrosomal antibodies (P =.043) than those without BH. However, in the multivariate analysis after adjusting for different follow-up periods in the 2 groups, only lighter resected tissue weight (P =.036) and concomitant thyroiditis on histology (P =.005) turned out to be independent factors for BH. Thyroiditis on histology was also the only significant risk factor for developing early onset BH. Conclusions: Patients with lighter resected tissue weight and concomitant thyroiditis on histology were particularly at risk for subsequent BH. Although not all patients with thyroiditis developed BH, in those who did develop BH it occurred within the first 11 months. © 2012 Elsevier Inc. All rights reserved.-
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/amjsurg-
dc.relation.ispartofThe American Journal of Surgeryen_US
dc.subjectHemithyroidectomy-
dc.subjectHypothyroidism-
dc.subjectSurgical outcome-
dc.subjectThyroid cancer-
dc.subjectThyroidectomy-
dc.subjectThyroiditis-
dc.subject.meshBiochemical Phenomena-
dc.subject.meshHypothyroidism - blood - epidemiology - etiology-
dc.subject.meshPostoperative Complications - blood - epidemiology-
dc.subject.meshThyroid Neoplasms - pathology - surgery-
dc.subject.meshThyroidectomy - adverse effects - methods-
dc.titleClinicopathologic predictors for early and late biochemical hypothyroidism after hemithyroidectomyen_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: blang@hkucc.hku.hken_US
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.amjsurg.2011.03.004en_US
dc.identifier.pmid21703593-
dc.identifier.scopuseid_2-s2.0-84859108585en_US
dc.identifier.hkuros187597en_US
dc.identifier.volume203-
dc.identifier.issue4-
dc.identifier.spage461en_US
dc.identifier.epage466en_US
dc.identifier.isiWOS:000302913700009-
dc.publisher.placeUnited States-
dc.identifier.citeulike9489138-
dc.identifier.issnl0002-9610-

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