Posthemithyroidectomy hypothyroidism. Prevalence and predictive markers. Comparison between patients with euthyroid and hyperthyroid nodular goitre

• Published in: Endocrinología, diabetes y nutrición. diabetes y nutrición., 2024-08, Vol.71 (7), p.298-307
• Main Authors: García Pascual, Luis, Puig-Jové, Carlos, Simó-Servat, Andreu, García-González, Lluís
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers - blood; Cross-Sectional Studies; Female; Goiter, Nodular - epidemiology; Goiter, Nodular - surgery; Hemithyroidectomy; Hemitiroidectomía; Hipotiroidismo; Hipotiroidismo postoperatorio; Humans; Hyperthyroidism - blood; Hyperthyroidism - epidemiology; Hyperthyroidism - surgery; Hypothyroidism; Hypothyroidism - blood; Hypothyroidism - epidemiology; Hypothyroidism - etiology; Male; Middle Aged; Postoperative Complications - blood; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative hypothyroidism; Prevalence; Retrospective Studies; Thyroidectomy; Thyrotropin - blood
• ISSN: 2530-0180; 2530-0180
• DOI: 10.1016/j.endien.2024.05.003

Posthemithyroidectomy hypothyroidism (PHH) is a relatively common complication (22%–30%) for which we have no published information from our country. The objective of the study is to determine the prevalence of PHH and evaluate its predictive markers by comparing patients who had euthyroidism with those who had hyperthyroidism before hemithyroidectomy. Retrospective observational cross-sectional study on 106 patients, 88 euthyroid before hemithyroidectomy and 18 hyperthyroid. Prevalence of PHH in euthyroid patients 42% (89.2% subclinical hypothyroidism; 10.8% manifest hypothyroidism) and in hyperthyroid patients 50% (77.8% subclinical hypothyroidism; 22.2% manifest hypothyroidism). Predictive markers in euthyroid patients: preoperative thyrotropin ≥ 2.2 mIU/L (OR: 4.278, 95% CI: 1.689−10.833; sensitivity: 54.1%, 95% CI: 38%–70.1%; specificity: 78.4%, 95% CI: 67.1%–89.7%), age ≥50 years (OR: 3.509, 95% CI: 1.438–8.563; sensitivity: 64.9%, 95% CI: 49.5%–80.3%; specificity: 64.7%, 95% CI: 51.6%–77.8%) and percentage of remainder lobe ≤ 19.6% (OR: 1.024, 95%: 1.002–1.046; sensitivity: 70.2%, 95% CI: 55.5%–84.9%; specificity: 48.6%, 95% CI: 34.9%–62.3%). Predictive marker in hyperthyroid patients: weight >70 kg (OR: 28, 95% CI: 2.067–379.247; sensitivity: 88.9%, 95% CI: 68.4%–100%; specificity: 88.9%, 95% CI: 68.4%–100%). This is the first study in our country that demonstrates a prevalence of PHH above the average in euthyroid patients, which is slightly higher and more intense in hyperthyroid patients, and that recognizes the classic predictive markers in euthyroid patients but highlights a novel predictive marker marker in hyperthyroid patients, useful to assess a different risk of PHH when indicating hemithyroidectomy and to establish closer control of postoperative hormonal evolution. El hipotiroidismo posthemitiroidectomía (HPH) es una complicación relativamente frecuente (22%–30%) de la que no tenemos información publicada de nuestro país. El objetivo del estudio es determinar la prevalencia del HPH y evaluar sus marcadores predictivos comparando los pacientes eutiroideos con los que tuvieron hipertiroidismo antes de la hemitiroidectomía. Estudio retrospectivo observacional transversal sobre 106 pacientes, 88 eutiroideos antes de la hemitiroidectomía y 18 hipertiroideos. Prevalencia de HPH en los pacientes eutiroideos 42% (89,2% hipotiroidismo subclínico; 10,8% hipotiroidismo manifiesto) y en los hipertiroideos 50% (77,8% hipotiroidismo subclínico; 22,2%