Background
Methods
Statistical analysis
Results
Variablea | Value |
---|---|
Gender, n (%) | 400 (100) |
Female | 349 (87.2) |
Male | 51 (12.8) |
Age in years, mean (SD) | 57.2 (13.4) |
Weight in kg, mean (SD) | 79.2 (15.8) |
Thyrotoxicosis before surgery, n (%) | |
No | 277 (69.2) |
<10 years | 105 (26.3) |
≥10 years | 18 (4.5) |
Graves’ disease, n (%) | |
No | 379 (94.7) |
Yes | 21 (5.3) |
Recurrent goiter, n (%) | |
No | 397 (99.2) |
Yes | 3 (0.8) |
Retrosternal goiter, n (%) | |
No | 393 (98.2) |
Yes | 7 (1.8) |
Bone mass density, T level, n (%) | |
No | 394 (98.5) |
Yes | 6 (1.5) |
Preoperative calcium, mmol/L, mean (SD) | 2.36 (0.10) |
MD (IQR) | 2.36 (0.12) |
Preoperative ionized calcium, mmol/L, mean (SD) | 1.06 (0.08) |
MD (IQR) | 1.04 (0.07) |
Preoperative PTH, ng/L (pg/mL), mean (SD) | 57.71 (22.27) |
MD (IQR) | 53.90 (26.63) |
Preoperative 25-hydroxyvitamin D, nmol/L, mean (SD) | 45.27 (22.03) |
MD (IQR) | 41.78 (29.72) |
Preoperative TSH, mlU/L, mean (SD) | 0.94 (1.22) |
MD (IQR) | 0.75 (1.22) |
Preoperative FT3, pmol/L, mean (SD) | 4.87 (2.36) |
MD (IQR) | 4.66 (0.84) |
Preoperative FT4, pmol/L, mean (SD) | 13.31 (2.69) |
MD (IQR) | 13.43 (2.71) |
Thyroidectomy without lymphadenectomy, n (%) | 400 (100) |
No | 66 (16.5) |
Yes | 334 (83.5) |
Thyroidectomy with one sided central lymphadenectomy, n (%) | |
No | 344 (86.0) |
Yes | 56 (14.0) |
Thyroidectomy with central lymphadenectomy on both sides, n (%) | |
No | 390 (97.5) |
Yes | 10 (2.5) |
Number of observed parathyroid glands, n (%) | |
0 | 2 (0.5) |
1 | 8 (2.0) |
2 | 97 (24.2) |
3 | 208 (52.0) |
4 | 85 (21.3) |
Upper branch of left inferior thyroid artery, n (%) | |
Non-ligation | 363 (90.7) |
Ligation | 37 (9.3) |
Lower branch of left inferior thyroid artery, n (%) | |
Non-ligation | 366 (91.5) |
Ligation | 34 (8.5) |
Trunk of left inferior thyroid artery, n (%) | |
Non-ligation | 90 (22.5) |
Ligation | 310 (77.5) |
Upper branch of right inferior thyroid artery, n (%) | |
Non-ligation | 358 (89.5) |
Ligation | 42 (10.5) |
Lower branch of right inferior thyroid artery, n (%) | |
Non-ligation | 366 (91.5) |
Ligation | 34 (8.5) |
Trunk of right inferior thyroid artery, n (%) | |
Non-ligation | 91 (22.8) |
Ligation | 309 (77.2) |
Number of darkened parathyroid glands at the end of surgery, n (%) | |
0 | 305 (76.2) |
1 | 80 (20.0) |
2 | 9 (2.3) |
3 | 6 (1.5) |
Parathyroid gland hematoma, n (%) | |
No | 379 (94.7) |
Yes | 21 (5.3) |
Number of autotransplanted parathyroid glands, n (%) | |
0 | 332 (83.0) |
1 | 54 (13.4) |
2 | 11 (2.8) |
3 | 3 (0.8) |
Adenomatous nodules, n (%) | |
No | 334 (83.5) |
Yes | 66 (16.5) |
Colloidal nodules, n (%) | |
No | 130 (32.5) |
Yes | 270 (67.5) |
Papillary carcinoma, n (%) | |
No | 320 (80.0) |
Yes | 80 (20.0) |
Follicular carcinoma, n (%) | |
No | 399 (99.7) |
Yes | 1 (0.3) |
Medullary carcinoma, n (%) | |
No | 397 (99.3) |
Yes | 3 (0.8) |
Anaplastic carcinoma, n (%) | |
No | 400 (100) |
Autoimmune thyroiditis, n (%) | |
No | 363 (90.7) |
Yes | 37 (9.3) |
Calcium day one, mmol/L, mean (SD) | 2.12 (0.14) |
MD (IQR) | 2.11 (0.20) |
Ionized calcium day one, mmol/L, mean (SD) | 0.99 (0.08) |
MD (IQR) | 0.99 (0.10) |
PTH day one, ng/L (pg/mL), mean (SD) | 29.98 (19.46) |
MD (IQR) | 29.06 (27.61) |
Calcium day two, mmol/L, mean (SD) | 2.05 (0.16) |
MD (IQR) | 2.06 (0.22) |
Ionized calcium day two, mmol/L, mean (SD) | 0.98 (0.09) |
MD (IQR) | 0.98 (0.11) |
Revision for bleeding, n (%) | |
No | 396 (99.0) |
Yes | 4 (1.0) |
Wound infection, n (%) | |
No | 400 (100) |
Wound hematoma, n (%) | |
No | 389 (97.2) |
Yes | 11 (2.8) |
Bleeding during surgery, n (%) | |
No | 399 (99.7) |
Yes | 1 (0.3) |
Clinical voice hoarseness, n (%) | |
No | 384 (96.0) |
Yes | 16 (4.0) |
Recurrent laryngeal nerve paralysis on one side, ORL, n (%) | |
No | 392 (98.0) |
Yes | 8 (2.0) |
Recurrent laryngeal nerve paralysis on both sides, ORL, n (%) | |
No | 400 (100) |
Clinical manifestation of hypocalcemia, n (%) | |
None | 340 (85.0) |
Day one | 14 (3.5) |
Day two | 46 (11.5) |
Hypocalcemia without clinical manifestation, n (%) | |
No | 203 (50.7) |
Yes | 197 (49.3) |
Hypocalcemia - Chvostekʼs symptoms, n (%) | |
No | 386 (96.5) |
Yes | 14 (3.5) |
Hypocalcemia - Trousseau’s symptoms, n (%) | |
No | 392 (98.0) |
Yes | 8 (2.0) |
Hypocalcemia - Numbness of fingers, n (%) | |
No | 342 (85.5) |
Yes | 58 (14.5) |
Hypocalcemia, n (%) | |
No | 143 (35.8) |
Yes | 257 (64.2) |
Treatment commenced in hospital with calcium and vitamin D preparations after surgery, n (%) | |
None | 161 (40.3) |
Day 1 | 15 (3.8) |
Day 2 | 33 (8.3) |
Day 3 | 5 (1.3) |
On discharge | 186 (46.5) |
Variablesa | Hypocalcemia | p value | |
---|---|---|---|
Yes | No | ||
Gender, n (%) | 257 | 143 | |
Female | 221 (63.3) | 128 (36.7) | χ2 = 1.02, df = 1, p = 0.351 |
Male | 36 (70.6) | 15 (29.4) | |
Age in years, mean (SD) | 57.8 (13.2) | 56.0 (13.8) | 0.207 |
Weight, kg., mean (SD) | 79.0 (15.2) | 79.5 (16.8) | 0.721 |
Thyrotoxicosis before surgery, n (%) | |||
No | 170 (66.1) | 107 (74.8) | χ2 = 4.10, df = 2, p = 0.129 |
<10 years | 76 (29.6) | 29 (20.3) | |
≥10 years | 11 (4.3) | 7 (4.9) | |
Graves’ disease, n (%) | |||
No | 241 (93.8) | 138 (96.5) | χ2 = 1.38, df = 1, p = 0.350 |
Yes | 16 (6.2) | 5 (3.5) | |
Recurrent goiter, n (%) | |||
No | 254 (98.8) | 143 (100) | χ2 = 1.68, df = 1, p = 0.556 |
Yes | 3 (1.2) | 0 | |
Retrosternal goiter, n (%) | |||
No | 250 (97.3) | 143 (100) | χ2 = 3.96, df = 1, p = 0.053 |
Yes | 7 (2.7) | 0 | |
Bone mass density, T level, n (%) | |||
No | 394 (98.5) | 394 (98.5) | χ2 = 0.54, df = 1, p = 0.671 |
Yes | 6 (1.5) | 6 (1.5) | |
Preoperative calcium, mmol/L, mean (SD)b | 2.35 (0.09) | 2.39 (0.11) | < 0.001 |
MD (IQR) | 2.35 (0.11) | 2.39 (0.12) | |
Preoperative ionized calcium, mmol/L, mean (SD)b | 1.04 (0.07) | 1.08 (0.10) | < 0.001 |
MD (IQR) | 1.03 (0.07) | 1.07 (0.09) | |
Preoperative PTH, ng/L (pg/mL), mean (SD)b | 57.86 (22.18) | 57.43 (22.50) | 0.855 |
MD (IQR) | 54.17 (26.38) | 53.65 (26.05) | |
Preoperative 25-hydroxyvitamin D, nmol/L, mean (SD)c | 44.22 (22.97) | 47.16 (20.17) | 0.053 |
MD (IQR) | 40.35 (30.47) | 46.40 (26.69) | |
Preoperative TSH, mlU/L, mean (SD)c | 1.12 (1.33) | 0.96 (0.97) | 0.355 |
MD (IQR) | 0.80 (1.20) | 0.70 (1.17) | |
Preoperative FT3, pmol/L, mean (SD)b | 4.85 (2.73) | 4.90 (1.50) | 0.854 |
MD (IQR) | 4.60 (0.83) | 4.71 (0.93) | |
Preoperative FT4, pmol/L, mean (SD)b | 13.53 (2.47) | 13.67 (3.05) | 0.626 |
MD (IQR) | 13.45 (2.92) | 13.40 (2.36) | |
Thyroidectomy without lymphadenectomy, n (%) | |||
No | 48 (18.7) | 18 (12.6) | χ2 = 2.47, df = 1, p = 0.124 |
Yes | 209 (81.3) | 125 (87.4) | |
Thyroidectomy with one sided central lymphadenectomy, n (%) | |||
No | 216 (84.0) | 128 (89.5) | χ2 = 2.28, df = 1, p = 0.175 |
Yes | 41 (16.0) | 15 (10.5) | |
Thyroidectomy with central lymphadenectomy on both sides, n (%) | |||
No | 250 (97.3) | 140 (97.9) | χ2 = 0.15, df = 1, p = 1.000 |
Yes | 7 (2.7) | 3 (2.1) | |
Number of observed parathyroid glands, n (%) | |||
0 | 2 (0.8) | 0 | χ2 = 35.23, df = 4, p < 0.001 |
1 | 3 (1.2) | 5 (3.5) | |
2 | 76 (29.6)** | 21 (14.7)** | |
3 | 142 (55.3) | 66 (46.2) | |
4 | 34 (13.2)*** | 51 (36.7)*** | |
Upper branch of left inferior thyroid artery, n (%) | |||
Non-ligation | 231 (89.9) | 132 (92.3) | χ2 = 0.64, df = 1, p = 0.475 |
Ligation | 26 (10.1) | 11 (7.7) | |
Lower branch of left inferior thyroid artery, n (%) | |||
Non-ligation | 232 (90.3) | 134 (93.7) | χ2 = 1.39, df = 1, p = 0.267 |
Ligation | 25 (9.7) | 9 (6.3) | |
Trunk of left inferior thyroid artery, n (%) | |||
Non-ligation | 46 (17.9) | 44 (30.8) | χ2 = 8.73, df = 1, p = 0.003 |
Ligation | 211 (82.1) | 99 (69.2) | |
Upper branch of right inferior thyroid artery, n (%) | |||
Non-ligation | 232 (90.3) | 126 (88.1) | χ2 = 0.46, df = 1, p = 0.501 |
Ligation | 25 (9.7) | 17 (11.9) | |
Lower branch of right inferior thyroid artery, n (%) | |||
Non-ligation | 231 (89.9) | 135 (94.4) | χ2 = 2.42, df = 1, p = 0.137 |
Ligation | 26 (10.1) | 8 (5.6) | |
Trunk of right inferior thyroid artery, n (%) | |||
Non-ligation | 44 (17.1) | 47 (32.9) | χ2 = 12.96, df = 1, p < 0.001 |
Ligation | 213 (82.9) | 96 (67.1) | |
Number of darkened parathyroid glands at the end of surgery, n (%) | |||
0 | 194 (75.5) | 111 (77.6) | χ2 = 3.64, df = 3, p = 0.303 |
1 | 54 (21.0) | 26 (18.2) | |
2 | 7 (2.7) | 2 (1.4) | |
3 | 2 (0.8) | 4 (2.8) | |
Parathyroid gland hematoma, n (%) | |||
No | 244 (94.9) | 135 (94.4) | χ2 = 0.05, df = 1, p = 0.818 |
Yes | 13 (5.1) | 8 (5.6) | |
Number of autotransplanted parathyroid glands, n (%) | |||
0 | 205 (79.8)* | 127 (88.8)* | χ2 = 6.32, df = 3, p = 0.097 |
1 | 40 (15.6) | 14 (9.8) | |
2 | 9 (3.5) | 2 (1.4) | |
3 | 3 (1.2) | 0 | |
Adenomatous nodules, n (%) | |||
No | 218 (84.8) | 116 (81.1) | χ2 = 0.92, df = 1, p = 0.399 |
Yes | 39 (15.2) | 27 (18.9) | |
Colloidal nodules, n (%) | |||
No | 81 (31.5) | 49 (34.3) | χ2 = 0.32, df = 1, p = 0.579 |
Yes | 176 (68.5) | 94 (65.7) | |
Papillary carcinoma, n (%) | |||
No | 203 (79.0) | 142 (99.3) | χ2 = 0.46, df = 1, p = 0.518 |
Yes | 54 (21.0) | 26 (18.2) | |
Follicular carcinoma, n (%) | |||
No | 257 (100) | 399 (99.3) | χ2 = 1.80, df = 1, p = 0.358 |
Yes | 0 | 1 (0.7) | |
Medullary carcinoma, n (%) | |||
No | 254 (98.8) | 143 (100) | χ2 = 1.68, df = 1, p = 0.556 |
Yes | 3 (1.2) | 0 | |
Anaplastic carcinoma, n (%) | |||
No | 257 (100) | 143 (100) | |
Autoimmune thyroiditis, n (%) | |||
No | 234 (91.1) | 129 (90.2) | χ2 = 0.08, df = 1, p = 0.857 |
Yes | 23 (8.9) | 14 (9.8) | |
Calcium day one, mmol/L, mean (SD) | 2.05 (0.12) | 2.24 (0.11) | < 0.001 |
MD (IQR) | 2.05 (0.16) | 2.25 (0.13) | |
Ionized calcium day one, mmol/L, mean (SD) | 0.96 (0.07) | 1.06 (0.07) | < 0.001 |
MD (IQR) | 0.96 (0.08) | 1.05 (0.09) | |
PTH, ng/L (pg/mL), mean (SD) | 24.42 (18.27) | 39.97 (17.50) | < 0.001 |
MD (IQR) | 21.47 (29.24) | 38.09 (20.86) | |
Calcium day two, mmol/L, mean (SD) | 1.96 (0.12) | 2.20 (0.08) | < 0.001 |
MD (IQR) | 1.99 (0.18) | 2.19 (0.11) | |
Ionized calcium day two, mmol/L, mean (SD) | 0.94 (0.07) | 1.06 (0.07) | < 0.001 |
MD (IQR) | 0.94 (0.09) | 1.05 (0.08) | |
Revision for bleeding, n (%) | |||
No | 254 (98.8) | 142 (99.3) | χ2 = 0.20, df = 1, p = 1.000 |
Yes | 3 (1.2) | 1 (0.7) | |
Wound infection, n (%) | |||
No | 257 (100) | 143 (100) | |
Wound hematoma, n (%) | |||
No | 249 (96.9) | 140 (97.9) | χ2 = 0.35, df = 1, p = 0.753 |
Yes | 8 (3.1) | 3 (2.1) | |
Bleeding during surgery, n (%) | |||
No | 256 (99.6) | 143 (100) | χ2 = 0.56, df = 1, p = 1.000 |
Yes | 1 (0.4) | 0 | |
Clinical voice hoarseness, n (%) | |||
No | 245 (95.3) | 139 (97.2) | χ2 = 0.84, df = 1, p = 0.434 |
Yes | 12 (4.7) | 4 (2.8) | |
Recurrent laryngeal nerve paralysis on one side, ORL, n (%) | |||
No | 252 (98.1) | 140 (97.9) | χ2 = 0.84, df = 1, p = 0.434 |
Yes | 5 (1.9) | 3 (2.1) | |
Recurrent laryngeal nerve paralysis on both sides, ORL, n (%) | |||
No | 257 (100) | 143 (100) | |
Clinical manifestation of hypocalcemia, n (%) | |||
None | 197 (76.7) | 143 (100) | χ2 = 39.27, df = 2, p < 0.001 |
Day 1 | 14 (3.5) | 0 | |
Day 2 | 46 (17.9) | 0 | |
Hypocalcemia without clinical manifestation, n (%) | |||
No | 60 (23.3) | 143 (100) | χ2 = 215.99, df = 1, p < 0.001 |
Yes | 197 (76.7) | 0 | |
Hypocalcemia - Chvostekʼs symptoms, n (%) | |||
No | 243 (94.6) | 143 (100) | χ2 = 8.07, df = 1, p = 0.004 |
Yes | 14 (5.4) | 0 | |
Hypocalcemia - Trousseau’s symptoms, n (%) | |||
No | 249 (96.9) | 143 (100) | χ2 = 4.54, df = 1, p = 0.033 |
Yes | 8 (2.0) | 0 | |
Hypocalcemia - Numbness of fingers, n (%) | |||
No | 199 (77.4) | 143 (100) | χ2 = 37.75, df = 1, p < 0.001 |
Yes | 58 (22.6) | 0 | |
Treatment commenced in hospital with calcium and vitamin D preparations after surgery, n (%) | |||
None | 23 (8.9) | 139 (97.2) | χ2 = 297.04, df = 4, p < 0.001 |
Day 1 | 15 (5.8) | 0) | |
Day 2 | 33 (12.8) | 0 | |
Day 3 | 5 (1.9) | 0 | |
On discharge | 181 (70.3) | 4 (2.8) |
Variable | OR | 95% CI |
p
|
---|---|---|---|
Thyrotoxicosis before surgery: no | 1 | 0.132 | |
<10 years | 1.65 | 1.01–2.70 | 0.046 |
>10 years | 0.99 | 0.37–2.63 | 0.982 |
Thyroidectomy without lymphadenectomy | 0.63 | 0.35–1.13 | 0.118 |
Thyroidectomy with one sided central lymphadenectomy | 1.62 | 0.86–3.04 | 0.134 |
Thyroidectomy with central lymphadenectomy on both sides | 1.31 | 0.33–5.13 | 0.702 |
Upper branch of left inferior thyroid artery, ligation | 0.74 | 0.35–1.55 | 0.424 |
Lower branch of left inferior thyroid artery, ligation | 0.62 | 0.28–1.38 | 0.241 |
Trunk of left inferior thyroid artery, ligation | 2.04 | 1.27–3.29 | 0.003 |
Upper branch of right inferior thyroid artery, ligation | 1.25 | 0.65–2.41 | 0.500 |
Lower branch of right inferior thyroid artery, ligation | 1.90 | 0.84–4.31 | 0.125 |
Trunk of right inferior thyroid artery, ligation | 2.37 | 1.47–3.82 | <0.001 |
Number of darkened parathyroid glands at the end of surgery | 0.98 | 0.69–1.39 | 0.925 |
Parathyroid gland hematoma | 0.90 | 0.36–2.22 | 0.818 |
Adenomatous nodules | 0.77 | 0.45–1.32 | 0.339 |
Colloidal nodules | 1.13 | 0.73–1.75 | 0.574 |
Papillary carcinoma | 1.20 | 0.71–2.01 | 0.498 |
Autoimmune thyroiditis | 0.91 | 0.45–1.82 | 0.781 |
Graves’ disease | 0.55 | 0.20–1.52 | 0.247 |
Calcium before surgery | 0.01 | 1.01–0.57 | <0.001 |
Calcium, day 1 after surgery | 0.00 | 0.00–0.00 | <0.001 |
Calcium, day 2 after surgery | 0.00 | 0.00–0.00 | <0.001 |
Ionized calcium before surgery | 0.001 | 0.000–0.013 | <0.001 |
Ionized calcium, day 1 after surgery | 0.00 | 0.00–0.00 | <0.001 |
Ionized calcium, day 2 after surgery | 0.00 | 0.00–0.00 | <0.001 |
PTH before surgery | 1.00 | 0.99–1.01 | 0.854 |
PTH, day 1 after surgery | 0.96 | 0.94–0.97 | <0.001 |
25-hydroxyvitamin D before surgery | 0.99 | 0.99–1.00 | 0.201 |
TSH before surgery | 1.13 | 0.94–1.36 | 0.197 |
FT4 before surgery | 0.98 | 0.91–1.06 | 0.625 |
FT3 before surgery | 0.99 | 0.91–1.08 | 0.854 |
Variable | OR | 95% CI |
p
|
---|---|---|---|
Age | 1.05 | 1.01–1.09 | 0.029 |
Gender | 5.94 | 1.13–31.26 | 0.035 |
Calcium, second day after surgery | 0.00 | 0.00–0.00 | <0.001 |