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Medicine (Baltimore). 2017 Oct;96(43):e8245. doi: 10.1097/MD.0000000000008245.

The impact of different surgical procedures on hypoparathyroidism after thyroidectomy: A population-based study.

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aGraduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan bInternational Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan cDepartment of Dermatology, Wan Fang Hospital, Taipei, Taiwan dDivision of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan eSchool of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan fSchool of Health Care Administration, Taipei Medical University, Taipei, Taiwan gFaculty of Health Sciences, Macau University of Science and Technology, Macau, China hMaster Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan.


The main objective of this study is to investigate the outcome between surgical procedures and the risk of development of hypoparathyroidism followed by surgical procedure in patients with thyroid disorders.We analyzed the data acquired from Taiwan's Bureau of National Health Insurance (BNHI) research database from 1998 to 2011 and found 9316 patients with thyroid surgery. Cox regression model was used to calculate the hazard ratio (HR).A count of 314 cases (3.4%) of hypoparathyroidism was identified. The 9 years cumulated incidence of hypoparathyroidism was the highest in patient undergone bilateral total thyroidectomy (13.5%) and the lowest in the patient with unilateral subtotal thyroidectomy (1.2%). However, in the patients who had undergone unilateral subtotal, the risk was the highest in bilateral total (HR: 11.86), followed by radical thyroidectomy with unilateral neck lymph node dissection (HR: 8.56), unilateral total (HR, 4.39), and one side total and another side subtotal (HR: 2.80).The extent of thyroid resection determined the risk of development of hypoparathyroidism. It is suggested that the association of these factors is investigated in future studies.

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