The first biological choice in patients with rheumatoid arthritis: data from the Moroccan register of biotherapies

Abstract Background: The aim of our study is to determine, from data of the Moroccan register of biotherapies, the factors influencing the choice of the first prescribed biological treatment.Methods: Cross-sectional multicenter study including rheumatoid arthritis patients who were initiated the first biological treatment either: Rituximab, an anti-TNF, or Tocilizumab. The determinants related to the patient and disease have been gathered. A univariate and then multivariate analysis to determine the factors associated with the choice of the first bDMARDs was realized.Results: A total of 225 rheumatoid arthritis patients were included in the Moroccan registry. The mean age was 52 ± 11 years, with female predominance 88% (n = 197). The first prescribed biological treatment was Rituximab 74% (n = 166), the second one was Tocilizumab, 13.6% (n = 31) then comes the anti-TNF in 3rd position with 12.4% (n = 28). The factors associated with the choice of Rituximab as the first line bDMARDs prescribed in univariate analysis were: the insurance type, the positivity of the rheumatoid factor. In multivariate analysis, only the insurance type that remains associated with the choice of Rituximab as the first biological drugs. The Tocilizumab was associated with shorter disease duration and was more prescribed as mono-therapy compared to non Tocilizumab group. TNFi was associated with the insurance type.Conclusion: Our study suggests that Rituximab and TNFi are associated with the type of insurance and Tocilizumab is the most prescribed biologic mono-therapy in RA patients. Further studies are needed to confirm these results.

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Factors Associated Sexual Dysfunction in Patients Pelvic Organ Prolapse at Dr. Cipto Mangunkusumo and Fatmawati Hospital Jakarta in 2016

Advanced Science Letters ◽

10.1166/asl.2018.12658 ◽

2018 ◽

Vol 24 (8) ◽

pp. 6147-6150

Author(s):

Suskhan Djusad ◽

Surahman Hakim ◽

Tyas Priyatini ◽

Fernandi Moegni ◽

Shirley Anggraeni ◽

...

Keyword(s):

Multivariate Analysis ◽

Pelvic Organ Prolapse ◽

Sexual Dysfunction ◽

Sexual Function ◽

Univariate Analysis ◽

Significant Risk ◽

Pelvic Organ ◽

Bivariate Analysis ◽

Cross Sectional ◽

Factors Associated

Pelvic Organ Prolapse (POP) is a bulge or protrusion of pelvic organs and related segments into or through the vagina. Disturbances in sexual function rarely complained, but from the literature it is known that patients with stage 3–4 prolapse associated with difficulty in achieving an orgasm. This study aims to determine the prevalence of sexual dysfunction in patients with POP and factors associated with sexual dysfunction among them. A cross-sectional design was conducted in Dr. Cipto Mangunkusumo and Fatmawati Hospital Jakarta. All patients who met the inclusion criteria of POP filled out a questionnaire of sexual function index (FSFI-19), then performed univariate analysis of data on the characteristics of the data subject, and bivariate and multivariate analysis to know the relationship between the dependent and independent variables. Of the 82 data, the prevalence of sexual dysfunction in patients with POP reached 57.3%. While most of the patients had experienced menopause POP also with a prevalence of 76.8%. The prevalence of sexual dysfunction in patients who were menopausal POP by 66.7%. From the results of the bivariate analysis, age, menopause, obesity and stage of prolapse were a significant risk factor on the incidence of sexual dysfunction in patients with POP. The variables of age, smoking, menopause, obesity and stage of prolapse, p < 0.25 to be included in the multivariate analysis. From the multivariate analysis, the variables associated with the incidence of sexual dysfunction in patients with POP were age >60 by OR 8 (IK95 2,45–26.12), and obesity (BMI 30 kg/m2) with an OR of 0.30 (CI 95 0.09 to 0.98). Advanced age and obesity are associated with the incidence of sexual dysfunction in patients with POP.

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Attitudes of patients with spondylarthritis or rheumatoid arthritis regarding biological treatment during COVID-19 pandemic: A multi-center, phone-based, cross-sectional study

Archives of Rheumatology ◽

10.46497/archrheumatol.2021.8364 ◽

2021 ◽

Author(s):

Coskun Zateri ◽

Murat Birtane ◽

İlknur Aktaş ◽

Selda Sarıkaya ◽

Aylin Rezvani ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Disease Activity ◽

Biological Treatment ◽

Treatment Plan ◽

Cross Sectional Study ◽

Infusion Therapy ◽

Health Staff ◽

Sectional Study ◽

Biological Drugs ◽

Cross Sectional

Objectives: In this study, we aimed to investigate the medical treatment attitudes of patients with spondylarthritis or rheumatoid arthritis (RA) who were using biological drugs during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: In this multi-center, cross-sectional study, a total of 277 patients (178 males, 99 females; median age: 45 years; range, 20 to 77 years) who were using biological disease-modifying anti-rheumatic drugs (bDMARDs) for rheumatic diseases and were reached by phone between June 1st, 2020 and June 30th, 2020 were included. Demographic characteristics, working status, type of the rheumatic disease, comorbidities, smoking habits, and type of the bDMARDs were recorded. Disease activity was evaluated using the Visual Analog Scale (VAS). The patients were asked whether they continued the treatment plan, as it was before or changed and, if changed, how they changed the plan and what happened after the change. Results: Of the patients, 229 had spondylarthritis and 48 had RA. A total of 36.1% of the patients were smokers, and the most common comorbidity was hypertension (17.3%). Totally, 5.8% of the patients had a history of contact with a COVID-19 positive person. Only three (1.1%) patients were diagnosed with COVID-19 infection and none of them died. Of the patients, 64.3% continued their treatment, while 35.7% adopted various changes. Most patients made the decision about the treatment plan on their own (n=160, 57.8%), while 38.3% of them consulted their physicians and 13.9% of them consulted any health staff. The only significant parameter for changing the drug course was receiving intravenous bDMARDs (by infusion at hospital) (p=0.001). These patients had also a higher disease activity as measured by VAS, compared to the patients receiving non-infusion therapy (p=0.021). As a result of these changes, severity of the symptoms increased in 91 (32.9%) patients. Disruption of regular biological treatment and prior infusion therapy more likely worsened the complaints (p<0.001 and p=0.024, respectively). Conclusion: Intravenous bDMARD therapy seems to be the main factor affecting the continuity of the treatment in the pandemic period. During the pandemic period, alternative treatment options should be considered other than infusion therapy not to interrupt the treatment of these patients.

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POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3126 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 900.1-900

Author(s):

L. Diebold ◽

T. Wirth ◽

V. Pradel ◽

N. Balandraud ◽

E. Fockens ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Disease Activity ◽

Univariate Analysis ◽

Route Of Administration ◽

Anxiety And Depression ◽

Administration Route ◽

Factors Associated ◽

The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

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Minor salivary gland biopsy: its importance in rheumatoid arthritis and secondary Sjögren's síndrome

Revista Argentina de Reumatología ◽

10.47196/rar.v30i3.442 ◽

2019 ◽

pp. 15-18

Author(s):

María Florencia Rodriguez ◽

Cristian Troitiño ◽

Felix Enrique Romanini ◽

Anastasia Secco

Keyword(s):

Rheumatoid Arthritis ◽

Multivariate Analysis ◽

Salivary Gland ◽

Interstitial Lung Disease ◽

Univariate Analysis ◽

Minor Salivary Gland ◽

Minor Salivary Gland Biopsy ◽

Extraglandular Manifestations ◽

Salivary Gland Biopsy

Secondary Sjögren’s Syndrome (SSs) is common in patients with Rheumatoid Arthritis (RA). Objectives: to determine if lymphocytic sialoadenifitis (FLS) is associated with clinical and serological differences in a group of patients with RA and SSs. Methods: patients with a diagnosis of RA and SSs were included, which of them presented FLS in the salivary gland biopsy, clinical and serological characteristics were compared. Results: 88 patients were included, 92% women, mean age of 53 years (SD ± 11.3) and 12.5 years of evolution of RA (RIC 6-7). 63.6% had SLF versus 36.4% who did not. In the univariate analysis, a statistically significant association was found between FLS + and the variables: parotidomegaly, interstitial lung disease, hypergammaglobulinemia, hypocomplementemia, rheumatoid factor, positive ANF, and extra-articular and/ or extraglandular manifestations. In the multivariate analysis, the variables independently associated with the presence of FLS were: extra-articular and/or extraglandular manifestations (OR 5.67, 95% CI 1.6-20), positive ANF (OR 11.7, 95% CI 1.6-83) and hypergammaglobulinemia (OR 21, 95% CI 2.46-179). Conclusion: patients with RA and SSs with FLS have a higher frequency of extra-articular and extraglandular manifestations and serological differences, which would imply a different clinical follow-up.

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Aspicular Bone Marrow Aspiration: A Common, but Not a Minor Problem

Blood ◽

10.1182/blood-2019-131662 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 5841-5841

Author(s):

Jose Angel Hawing ◽

Olga Graciela Cantu Rodriguez ◽

Andrés Gómez-De León ◽

Consuelo Mancias ◽

Luz del Carmen Tarín Arzaga ◽

...

Keyword(s):

Bone Marrow ◽

Flow Cytometry ◽

Multivariate Analysis ◽

Complete Blood Count ◽

Univariate Analysis ◽

Poor Quality ◽

University Hospital ◽

Operator Experience ◽

Factors Associated ◽

Morphological Diagnosis

Bone marrow (BM) aspiration plays an important role in hematologic malignancies diagnosis. Access and cost of diagnostic flow cytometry remains a problem in low and middle-income countries. In this context, morphological diagnosis by BM smear often represents the only means to rapidly diagnose our patients. Therefore, in this context obtaining the highest quality sample possible during the procedure is paramount. Despite being a well-known problem, evidence-based recommendations to improve BM aspirate quality are few, with studies evaluating factors associated with poor quality samples lacking. Objectives To determine factors associated with poor quality BM aspirates defined by an aspicular or hemodiluted sample in a hematology referral center. Materials and methods We conducted a retrospective study in our University Hospital and analyzed the BM smear samples stored in our center performed from October 2014 to December 2018. We collected and analyzed data based on diagnosis, age, gender, recent chemotherapy, and the variables of a complete blood count performed just before each BM aspiration. The quality of the BM smear was defined in any of the following: aspicular (without spicules), pauciaspicular (1-3 spicules), spicular (> 3 spicules), defining aspicular BM smear as non-diagnostic samples. Univariate analysis was performed looking for diferences between operators (in a 3-year residency program). In the other hand, in the multivariate analysis we seek to reveal the factors associated with obtaining hemodiluted (aspicular) bone marrow aspirate-smears. Results A total of 1,073 BM aspirates were evaluated. Hematology fellows performed 97% of BM aspirates; the remaining 3% were performed by attending physicians. In our analysis, 301 aspirates were aspicular, constituting 28.1% of the total number of aspirate smears. Most BM aspirates were performed for a diagnostic evaluation (66.3%) with the rest of the procedures for subsequent hematologic malignancy response assessments. In the univariate analysis, no differences were observed between operators. In a multivariate analysis the presence of an age >65 years (OR 3.1, 95% CI 2.3 to 4.1) and hemoglobin <6.0 g/dL (OR 2.7, 95% CI 1.4 to 4.5) at the time of the procedure were significantly associated to obtaining a non-diagnostic sample. Diagnosis, WBC count, platelet count, operator experience or other variables did not show statistical relevance. In our center, 18.81% of diagnostic patient samples that had acute leukemia were diagnosed without flow cytometry and through BM aspirate morphology alone. A second procedure to reach a diagnosis was necessary in 7.97% of the patients due to aspicular samples, obtaining a mean of diagnostic-treatment delay of 18.3 days (±5.7 days). Conclusions We found no differences between operators, emphasizing that there are other factors to consider in addition to a correct BM aspiration technique or operator experience. We believe this is crucial to recognize, especially in developing countries where morphological diagnosis remains the only means for the diagnosis or response evaluation of our patients. BM aspirate sample quality is multifactorial, being age and hemoglobin important factors. In addition, obtaining aspicular or hemodiluted samples represents not only a diagnostic challenge, but also delays the treatment of our patients. Disclosures Gomez-Almaguer: Celgene: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Teva: Consultancy, Speakers Bureau; Amgen: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau.

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Thirty-day readmission rate as a surrogate marker for quality of care in neurosurgical patients: a single-center Canadian experience

Journal of Neurosurgery ◽

10.3171/2018.2.jns172962 ◽

2019 ◽

Vol 130 (5) ◽

pp. 1692-1698 ◽

Cited By ~ 1

Author(s):

Mitchell P. Wilson ◽

Andrew S. Jack ◽

Andrew Nataraj ◽

Michael Chow

Keyword(s):

Multivariate Analysis ◽

Quality Of Care ◽

Readmission Rate ◽

Univariate Analysis ◽

Surrogate Marker ◽

Readmission Rates ◽

Factors Associated ◽

Neurosurgical Patients ◽

Avoidable Readmissions

OBJECTIVEReadmission to the hospital within 30 days of discharge is used as a surrogate marker for quality and value of care in the United States (US) healthcare system. Concern exists regarding the value of 30-day readmission as a quality of care metric in neurosurgical patients. Few studies have assessed 30-day readmission rates in neurosurgical patients outside the US. The authors performed a retrospective review of all adult neurosurgical patients admitted to a single Canadian neurosurgical academic center and who were discharged to home to assess for the all-cause 30-day readmission rate, unplanned 30-day readmission rate, and avoidable 30-day readmission rate.METHODSA retrospective review was performed assessing 30-day readmission rates after discharge to home in all neurosurgical patients admitted to a single academic neurosurgical center from January 1, 2011, to December 31, 2011. The primary outcomes included rates of all-cause, unplanned, and avoidable readmissions within 30 days of discharge. Secondary outcomes included factors associated with unplanned and avoidable 30-day readmissions.RESULTSA total of 184 of 950 patients (19.4%) were readmitted to the hospital within 30 days of discharge. One-hundred three patients (10.8%) were readmitted for an unplanned reason and 81 (8.5%) were readmitted for a planned or rescheduled operation. Only 19 readmissions (10%) were for a potentially avoidable reason. Univariate analysis identified factors associated with readmission for a complication or persistent/worsening symptom, including age (p = 0.009), length of stay (p = 0.007), general neurosurgery diagnosis (p < 0.001), cranial pathology (p < 0.001), intensive care unit (ICU) admission (p < 0.001), number of initial admission operations (p = 0.01), and shunt procedures (p < 0.001). Multivariate analysis identified predictive factors of readmission, including diagnosis (p = 0.002, OR 2.4, 95% CI 1.4–5.3), cranial pathology (p = 0.002, OR 2.7, 95% CI 1.4–5.3), ICU admission (p = 0.004, OR 2.4, 95% CI 1.3–4.2), and number of first admission operations (p = 0.01, OR 0.51, 95% CI 0.3–0.87). Univariate analysis performed to identify factors associated with potentially avoidable readmissions included length of stay (p = 0.03), diagnosis (p < 0.001), cranial pathology (p = 0.02), and shunt procedures (p < 0.001). Multivariate analysis identified only shunt procedures as a predictive factor for avoidable readmission (p = 0.02, OR 5.6, 95% CI 1.4–22.8).CONCLUSIONSAlmost one-fifth of neurosurgical patients were readmitted within 30 days of discharge. However, only about half of these patients were admitted for an unplanned reason, and only 10% of all readmissions were potentially avoidable. This study demonstrates unique challenges encountered in a publicly funded healthcare setting and supports the growing literature suggesting 30-day readmission rates may serve as an inappropriate quality of care metric in neurosurgical patients. Potentially avoidable readmissions can be predicted, and further research assessing predictors of avoidable readmissions is warranted.

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Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-019-0495-x ◽

2019 ◽

Vol 11 (1) ◽

Author(s):

Betsabe Contreras-Haro ◽

Sandra Ofelia Hernandez-Gonzalez ◽

Laura Gonzalez-Lopez ◽

Maria Claudia Espinel-Bermudez ◽

Leonel Garcia-Benavides ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Insulin Resistance ◽

Lupus Erythematosus ◽

Screening Test ◽

Systemic Lupus ◽

Cross Sectional ◽

Factors Associated ◽

Tyg Index ◽

Surrogate Index

Abstract Background Insulin resistance (IR) is frequently observed in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In clinical practice, IR assessment is limited to a low proportion of patients due to cost and equipment and technical expertise requirements. The surrogate index of triglycerides and glucose (TyG index) has been validated in non-rheumatic populations, showing adequate sensitivity and specificity for IR, although this index has not yet been used in connective tissue disorders. The aim of this study was to evaluate the frequency of insulin resistance (IR) using the validated surrogate index of triglycerides and glucose (TyG index) and to explore factors associated with IR in Mexican women with RA or SLE. Methods Ninety-five female RA and 57 SLE patients were included in a cross-sectional study. Clinical and epidemiological variables were evaluated. IR was assessed using the TyG index with a cutoff value of > 4.68. Logistic regression analysis was performed to identify factors associated with IR excluding confounders. Results IR frequency in the entire sample was 50%, higher than the 10% observed in non-rheumatic controls (p < 0.001). The frequency of IR was similar in SLE (49.1%) and RA (50.5%, p = 0.8) patients. IR was associated with a longer duration of hypertension and higher total cholesterol and low density lipoprotein cholesterol levels. Based on multivariate analysis, the duration of hypertension (OR: 1.06; 95% CI 1.002–1.12, p = 0.04), waist circumference (OR: 1.04; 95% CI 1.01–1.08, p = 0.007), uric acid levels (OR: 1.46; 95% CI 1.08–1.97, p = 0.01), RA (OR: 4.87; 95% CI 1.31–18.78, p = 0.01) and SLE (OR: 4.22; 95% CI 1.06–16.74, p = 0.04) were the main risk factors for IR. Conclusions This study shows that the TyG index is a useful screening test for IR in RA and SLE patients. Future longitudinal studies should be performed with the aim of identifying the predictive value of TyG index results for identifying complications linked to IR.

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Factors associated with asthma expression in adolescents

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562017000000078 ◽

2018 ◽

Vol 44 (1) ◽

pp. 12-17 ◽

Cited By ~ 1

Author(s):

Silvia de Souza Campos Fernandes ◽

Dirceu Solé ◽

Paulo Camargos ◽

Cláudia Ribeiro de Andrade ◽

Cássio da Cunha Ibiapina

Keyword(s):

Multivariate Analysis ◽

Public Schools ◽

Care Center ◽

Univariate Analysis ◽

Health Care Facilities ◽

Tobacco Smoke Exposure ◽

Farm Animals ◽

Analysis Model ◽

Factors Associated ◽

Asthma Symptoms

ABSTRACT Objective: To evaluate risk factors associated with asthma symptoms in adolescents in the 13- to 14-year age bracket. Methods: This was a cross-sectional study involving adolescents enrolled in randomly selected public schools in the city of Belo Horizonte, Brazil, and conducted with the use of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and its supplementary module for risk factor assessment. The ISAAC questionnaire was completed by the students themselves, whereas the supplementary questionnaire was completed by their parents or legal guardians. Variables showing p ≤ 0.25 in the univariate analysis were included in the multivariate analysis. Stepwise regression with backward elimination was used for variable selection. Results: We evaluated 375 adolescents, 124 (33.1%) of whom had asthma symptoms. The final multivariate analysis model revealed that asthma symptoms were associated with birth weight < 2,500 g (p < 0.001), day care center or nursery attendance (p < 0.002), maternal history of asthma (p < 0.001), contact with animals during the first year of life (p < 0.027), current contact with animals outside the home (dogs, cats, or farm animals; p < 0.005), and more than 20 cigarettes per day smoked by parents or other household members (p < 0.02). Conclusions: Exposure to animals in and outside the home is associated with asthma symptoms, as is environmental tobacco smoke exposure. Families, health professionals, and administrators of health care facilities should take that into account in order to prevent asthma and reduce asthma morbidity.

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Analysis of the incidence and factors predictive of inadvertent parathyroidectomy during thyroid surgery

The Journal of Laryngology & Otology ◽

10.1017/s0022215116008136 ◽

2016 ◽

Vol 130 (7) ◽

pp. 669-673 ◽

Cited By ~ 10

Author(s):

R W A Hone ◽

T Tikka ◽

A I Kaleva ◽

A Hoey ◽

V Alexander ◽

...

Keyword(s):

Multivariate Analysis ◽

Neck Dissection ◽

Independent Predictor ◽

Univariate Analysis ◽

Parathyroid Tissue ◽

Needle Aspiration ◽

Fourfold Increase ◽

Factors Associated ◽

Needle Aspiration Cytology ◽

Associated Risk Factors

AbstractBackground:Inadvertent (or incidental) parathyroidectomy can occur during thyroidectomy. However, the factors associated with inadvertent parathyroidectomy remain unclear. This study aimed to report the rate of inadvertent parathyroidectomy during thyroidectomy and associated risk factors.Methods:Variables including fine needle aspiration cytology findings, age, sex, thyroid weight, concurrent neck dissection, extent of thyroidectomy, and the presence of cancer and parathyroid tissue within the specimen were recorded for 266 patients. The incidence of post-operative hypocalcaemia was also recorded. Univariate and multivariate analysis were performed to identify factors associated with inadvertent parathyroidectomy.Results:The inadvertent parathyroidectomy rate was 16 per cent. Univariate analysis revealed that cancer and concurrent neck dissection predicted inadvertent parathyroidectomy. On multivariate analysis, only concurrent neck dissection remained an independent predictor of inadvertent parathyroidectomy: it was associated with a fourfold increase in inadvertent parathyroidectomy.Conclusion:The inadvertent parathyroidectomy rate was 16 per cent and concurrent neck dissection was identified as an independent predictor of inadvertent parathyroidectomy.

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