Study of hypocalcemia and its risk factors in post thyroidectomy among a sample of Iraqi patients

Background: Hypocalcemia is a well-recognized complication of thyroid surgery. The aim of this study was to determine the incidence of hypocalcemia after thyroid surgery and find out the risk factors involved regarding the patient age, gender, muscular build, clinical diagnosis, extent of surgery, ligation of the inferior thyroid artery, and pathology report.Methods: This prospective study was carried out on 50 patients who underwent thyroid surgery for various thyroid diseases at the surgical department of Karama teaching hospital for the period between January 2016 to July 2016. Serial serum calcium measurements were recorded as well as details of the operation, patient age and gender, ligation of the inferior thyroid artery or not, pathological report. Hypocalcemia was considered transient if it was resolved within 6months and permanent if it persist after 6months and the patient was maintained on supplementation therapy of calcium and vitamin D.Results: Author found that the incidence of post-thyroidectomy hypocalcemia was 30% and in the majority of the cases (24%) was transient, while it was permanent in only (6%) of cases and had occurred mainly after total thyroidectomy and in cases with ligation of the inferior thyroid artery.Conclusions: Author concluded that post thyroidectomy hypocalcemia is a relatively common complication but it is transient in the majority of the patients. Its incidence is related to the extent of the surgery and can be reduced by the good preparation of the patient preoperatively.

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The incidence and risk factors of hypocalcaemia after thyroid surgery

Journal of the Faculty of Medicine Baghdad ◽

10.32007/jfacmedbagdad.v60i1.32 ◽

2018 ◽

Vol 60 (1) ◽

pp. 9-13

Author(s):

Aws B. Abed ◽

Mohannad K. Al Bermani ◽

Waleed A. Salman

Keyword(s):

Risk Factors ◽

Total Thyroidectomy ◽

Thyroid Surgery ◽

Inferior Thyroid Artery ◽

Pathology Report ◽

Patient Age ◽

Transient Event ◽

Surgical Department ◽

Patient Âgé ◽

And Gender

Background: Hypocalcaemia is a well-recognized complication of thyroid surgery. It is the most often transient event that occurs after extensive thyroid resection that may require calcium and/or vitamin D supplements to alleviate or prevent the symptoms.Objective: of this study is to determine the incidence of hypocalcaemia after thyroid surgery and find out the risk factors involved regarding the patient age, gender, and muscular build, clinical diagnosis, the extent of surgery, ligation of the inferior thyroid artery, pathology report and the experience of the surgeon.Patients and methods: This prospective study was carried out on 100 patients who underwent thyroid surgery for various thyroid diseases at the surgical department of Baghdad teaching hospital in the period between November 2009 to November 2013.Serial serum calcium measurements were recorded as well as details of the operation, patient age and gender, ligation of the inferior thyroid artery or not, pathological report and experience of the operator. Hypocalcaemia was considered transient if it was resolved within 6 months and permanent if it persisted after 6 months and the patient was maintained on supplementation therapy of calcium and vitamin D.Results: We found that the incidence of post-thyroidectomy hypocalcaemia was 30 % and in the majority of the cases (24%) was transient, while it was permanent in only (6%) of cases and had occurred mainly after total thyroidectomy and in cases with ligation of the inferior thyroid artery.Conclusions: We concluded that post thyroidectomy hypocalcaemia is a relatively common complication, but it is transient in the majority of the patients. Its incidence is related to the extent of the surgery and can be reduced by the use of the correct surgical procedures.Keywords: hypocalcaemia, post thyroidectomy, total thyroidectomy, subtotal thyroidectomy قياس معدل انخفاض الكالسيوم في الدم بعد عمليات استئصال الغدة الدرقية وبحث العوامل المؤدية الى ذلك اوس بشير عبد العبد مهند كامل البيرماني وليد عبد الحسين سلمان الخلاصة: الخلفية : تعتبر انخفاض نسبة الكالسيوم من المضاعفات الشائغة بعد عمليات استئصال الغدة الدرقية .وفي معظم الاجيان يكون ذلك الانخفاض مؤقتا وليس دائميا .وتعتمد نسبة حدوثه على الحجم المستئصل من الغدة الدرقية وطبيعة الحالة المرضية للغدة وفيما اذا تم عقد الشريان السفلي المغذي للغدة الدرقية ام لا . الغرض: ان الغاية من البحث هو تحديد نسبة انخفاض الكالسيوم في بعد اجراء عمليات استاصال الغدة الدرقية وبحث العوامل المؤدية الى ذلك كعمر وجنس المريض وبنيته العضلية ,اضافة الى التشخيص السريري والنسيجي للغدة الدرقية ونوع العملية وفيما اذا قد تم عقد الشريان السفلي المغذي لها ام لا وخبرة الجراح. المرضى والطريقة : دراسة مقارنة مستقبلية في مستشفى بغداد التعليمي ابتداءا من الاول من تشرين الثاني 2009 ولغاية الاول من تشرين الثاني 2013 ,هذة الدراسة شملت 100 مريض من الذين اجريت لهم عمليات استئصال الغدة الدرقية الكامل وشبه الكامل والجزئي. وقد تم تسجيل ودراسة المعلومات المتعلقة بعمر وجنس المريض وبنيته العضلية اضافة الى التشخيص السريري والنسيجي للغدة الدرقية ونوع العملية وفيما اذا قد تم عقد الشريان السفلي المغذي لها اولا وخبرة الجراح تم قياس مستوى الكالسيوم في الدم في اليوم الاول والثاني والثالث بعد اجراء العملية وتم اعتبار مستوى نسبة الكالسيوم (8 ملي غرام / ديسي لتر) كالحد الطبيعي الادنى المقبول. اعتبرت حالة انخفاض الكالسيوم مؤقتة اذا ما استمرت النسبة منخفضة او استمرت الاعراض لاقل من 6 اشهر, ودائمية في حالة استمرارها لاكثر من ذلك مع حاجة المريض لجرعات مستمرة من الكالسيوم وفيتامين د عن طريق الفم. النتائج: لقد وجد ان معدل نسبة حدوث انخفاض الكالسيوم في الدم بعد عمليات استئصال الغدة الدرقية هي 30%وقد كانت مؤقتة في معضم الحالات(24%), ودائمية فقط في 6% وخاصة في حالات الاستئصال الكامل للغدة الدرقية وفي حالات عقد الشريان السفلي المغذي لها. الاستنتاج : ان انخفاض نسبة الكالسيوم في الدم بعد عمليات استئصال الغدة الدرقية هي ظاهرة شائعة الحدوث وخصوصا بعد عمليات الاستئصال الكلي للغدة الدرقية , ولكنها مؤقتة في معظم الحالات .وان نسبة حدوثها مرتبطة بمقدار الحجم المستئصل من الغدة الدرقية وفيما لو تم عقد الشريان السفلي المغذي لها ام لا , وانه بالامكان التقليل من نسبة حدوثها وذلك باتباع الطرق الجراحية الصحيحة . مفتاح الكلمات : انخفاض مستوى الكالسيوم في الدم,عملية استاصال الغدة الدرقية الكلي ,استاصال الغدة الدرقية الجزئي .

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Study of hypocalcemia and its risk factors in post thyroidectomy in Al-Karama Teaching Hospital

Journal of the Faculty of Medicine Baghdad ◽

10.32007/jfacmedbagdad.6041052 ◽

2019 ◽

Vol 60 (4) ◽

pp. 185-190

Author(s):

Mohammed H. Surriah ◽

Ahmed N. Hassan ◽

Amine M. Bakkour

Keyword(s):

Risk Factors ◽

Teaching Hospital ◽

Thyroid Surgery ◽

Case Series ◽

Inferior Thyroid Artery ◽

Pathology Report ◽

Surgical Department ◽

Case Series Study ◽

Extent Of Surgery ◽

And Gender

Background: Hypocalcemia is a well-recognized complication of thyroid surgery. The aim of this study was to determine the incidence of hypocalcemia after thyroid surgery and find out the risk factors involved regarding the patient’s age, gender, muscular build, clinical diagnosis, extent of surgery, ligation of the inferior thyroid artery, and pathology report. Patients and Methods: This case series study was carried out on 50 patients who have undergone thyroid surgery for various thyroid diseases at the surgical department of Al-Karama Teaching Hospital for the period between January 2016 and July 2017. Serial serum calcium measurements were recorded as well as details of the operation, patient’s age and gender, whether or not inferior thyroid artery was ligated, and the pathological report. Hypocalcemia was considered transient if it resolved within 6 months and permanent if it persisted after 6 months and the patient was maintained on supplementation therapy of calcium and vitamin D. Results: The study found that the incidence of post-thyroidectomy hypocalcemia was 30% and in the majority of the cases (24%) was transient, while it was permanent in only (6%) of the cases; and had occurred mainly after total thyroidectomy and in cases with ligation of the inferior thyroid artery. Conclusions: It was concluded that post thyroidectomy hypocalcemia is a relatively common complication but it is transient in the majority of the patients. Its incidence is related to the extent of the surgery and can be reduced by the good preparation of the patient preoperatively.

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Study of the risk factors for post-operative hypocalcemia after thyroid surgery

International Surgery Journal ◽

10.18203/2349-2902.isj20212711 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2085

Author(s):

Valarmathi M. ◽

Bhuvaneswari M.

Keyword(s):

Risk Factors ◽

Thyroid Surgery ◽

Hashimoto Thyroiditis ◽

Common Side Effect ◽

Age And Gender ◽

Thyroid Adenomas ◽

Toxic Multinodular Goiter ◽

Hospital Stays ◽

Serial Serum ◽

And Gender

Background: Hypocalcemia is still a common post-operative consequence following total thyroidectomy, generating potentially serious symptoms and concern in patients and lengthening hospital stays. This study was conducted to evaluate the risk factors for post-operative hypocalcemia after thyroid surgery.Methods: In this study, 60 patients who underwent thyroidectomy were included. Patients with concomitant lymph node dissection and hypocalcemia were excluded from the study. Serial serum calcium measures were taken and information about the operation, such as the patient's age and gender, whether the inferior thyroid artery was ligated or not, and the pathological report.Results: In 60 patients, 17 patients were had post-operative hypocalcemia. 3 in 5 patients (60%) with Hashimoto thyroiditis had hypocalcemia, followed by toxic multinodular goiter (MNG) (37.5%), thyroid adenomas (33.33%) and Graves’ disease (33.33%) had hypocalcemia after thyroidectomy.Conclusions: To conclude, hypocalcemia is a common side effect of total thyroid surgery, and it is caused by the unintentional removal of parathyroid glands or injury or spasm of the blood arteries that supply them.

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Hemmkörperentwicklung bei Hämophilie-Patienten nach Präparate wechsel

Hämostaseologie ◽

10.1055/s-0037-1619773 ◽

2012 ◽

Vol 32 (S 01) ◽

pp. S39-S42 ◽

Cited By ~ 1

Author(s):

S. Kocher ◽

G. Asmelash ◽

V. Makki ◽

S. Müller ◽

S. Krekeler ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Observational Study ◽

Retrospective Observational Study ◽

Frequent Change ◽

Patient Age ◽

Treatment Regimens ◽

Patient Âgé ◽

The Relationship ◽

Observation Period

SummaryThe retrospective observational study surveys the relationship between development of inhibitors in the treatment of haemophilia patients and risk factors such as changing FVIII products. A total of 119 patients were included in this study, 198 changes of FVIII products were evaluated. Results: During the observation period of 12 months none of the patients developed an inhibitor, which was temporally associated with a change of FVIII products. A frequent change of FVIII products didn’t lead to an increase in inhibitor risk. The change between plasmatic and recombinant preparations could not be confirmed as a risk factor. Furthermore, no correlation between treatment regimens, severity, patient age and comorbidities of the patients could be found.

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PO503 Impact of Patient Age and Gender On Primary Care Physician Adherence to National Guidelines For Common CVD

Global Heart ◽

10.1016/j.gheart.2018.09.387 ◽

2018 ◽

Vol 13 (4) ◽

pp. 485-486

Author(s):

O. Sokolova ◽

N. Pogosova ◽

S. Isakova ◽

A. Karpova

Keyword(s):

Primary Care ◽

Primary Care Physician ◽

Care Physician ◽

National Guidelines ◽

Patient Age ◽

Age And Gender ◽

Patient Âgé ◽

And Gender ◽

Physician Adherence

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Risk of hemorrhage from de novo cerebral aneurysms

Journal of Neurosurgery ◽

10.3171/2012.9.jns111512 ◽

2013 ◽

Vol 118 (1) ◽

pp. 58-62 ◽

Cited By ~ 22

Author(s):

William J. Kemp ◽

Daniel H. Fulkerson ◽

Troy D. Payner ◽

Thomas J. Leipzig ◽

Terry G. Horner ◽

...

Keyword(s):

Risk Factors ◽

De Novo ◽

Patient Age ◽

Patient Âgé ◽

Long Term Follow Up ◽

De Novo Aneurysm ◽

The Mean ◽

Risk Of Hemorrhage

Object A small percentage of patients will develop a completely new or de novo aneurysm after discovery of an initial aneurysm. The natural history of these lesions is unknown. The authors undertook this statistical evaluation a large cohort of patients with both ruptured and unruptured de novo aneurysms with the aim of analyzing risk factors for rupture and estimating a risk of subarachnoid hemorrhage (SAH). Methods A review of a prospectively maintained database of all aneurysm patients treated by the vascular neurosurgery service of Goodman Campbell Brain and Spine from 1976–2010 was performed. Of the 4718 patients, 611 (13%) had long-term follow-up imaging. The authors identified 27 patients (4.4%) with a total of 32 unruptured de novo aneurysms from routine surveillance imaging. They identified another 10 patients who presented with a new SAH from a de novo aneurysm after treatment of their original aneurysm. The total study group was thus 37 patients with a total of 42 de novo aneurysms. The authors then compared the 27 patients with incidentally discovered aneurysms with the 10 patients with SAH. A statistical analysis was performed, comparing the 2 groups with respect to patient and aneurysm characteristics and risk factors. Results Thirty-seven patients were identified as having true de novo aneurysms. This group had a female predominance and a high percentage of smokers. These 37 patients had a total of 42 de novo aneurysms. Ten of these 42 aneurysms hemorrhaged. De novo aneurysms in both the SAH and non-SAH group were anatomically small (< 10 mm). The estimated risk of hemorrhage over 5 years was 14.5%, higher than the expected SAH risk of small, unruptured aneurysms reported in the ISUIA (International Study of Unruptured Intracranial Aneurysms) trial. There was no statistically significant correlation between hemorrhage and any of the following risk factors: hypertension, diabetes, tobacco and alcohol use, polycystic kidney disease, or previous SAH. There was a statistically significant between-groups difference with respect to patient age, with the mean patient age being significantly older in the SAH aneurysm group than in the non-SAH group (p = 0.047). This is likely reflective of longer follow-up and discovery time, as the mean length of time between initial treatment and discovery of the de novo aneurysm was longer in the SAH group (p = 0.011). Conclusions While rare, de novo aneurysms may have a risk for SAH that is comparatively higher than the risk associated with similarly sized, small, initially discovered unruptured saccular aneurysms. The authors therefore recommend long-term follow-up for all patients with aneurysms, and they consider a more aggressive treatment strategy for de novo aneurysms than for incidentally discovered initial aneurysms.

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ADR evaluation of screening colonoscopies during 2016 – 2017 in a private health clinic in Peru

Endoscopy International Open ◽

10.1055/a-0672-1045 ◽

2018 ◽

Vol 06 (11) ◽

pp. E1304-E1309

Author(s):

Julio F. León Moreno

Keyword(s):

Screening Colonoscopy ◽

Health Clinic ◽

Cecal Intubation ◽

Patient Age ◽

Tertiary Referral Center ◽

Patient Âgé ◽

Adenoma Detection ◽

And Gender ◽

American Society ◽

Colonoscopy Quality

Abstract Background and study aims High-quality colonoscopy is fundamental for preventing colorectal cancer (CRC). The adenoma detection rate (ADR) is a key colonoscopy quality measure. The aim of this study was to establish the screening colonoscopy ADR of a tertiary referral center in Peru, identify the relationship between the ADR and patient age, sex and the colonoscopist, and determine the endoscopic and histopathological characteristics of the lesions found. Patients and methods A retrospective observational longitudinal study was undertaken between January 2016 and June 2017. Results Eight colonoscopists performed screening colonoscopies on 620 patients scoring ≥ 6 points on the Boston Bowel Preparation Scale (BBPS); cecal intubation was complete in 595 patients (cecal intubation rate [CIR] 95.9 %). The overall ADR was 29.7 % (females 25.4 %, males 33.1 %, P = 0.040, 95 %Cl). The ADR colonoscopist range was 25.0 % to 34.4 %. The highest ADR (41.2 %, P = 0.013, 95 %Cl) was for patients aged 65 to 75 years. Adenoma colon locations were: left 49 %, transverse 21.6 % and right 29.4 %. Adenoma dysplasia grades: low 98 %, high 2 %. Sixty-three percent of the lesions were 5 mm to 10 mm. Resections performed: 78.5 % cold biopsy forceps (CBF), 3.4 % cold snare polypectomy (CSP) and 18.1 % endoscopic mucosal resection (EMR). Conclusions The ADR established was in line with the joint American College of Gastroenterology (ACG)/American Society for Gastrointestinal Endoscopy (ASGE) recommendations and related to patient age and gender but not to the colonoscopist. Colonoscopists should ensure rigorous application of the colonoscopy quality actions. ADR should be evaluated frequently.

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