Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study

Objective Following thyroid lobectomy, patients are at risk for hypothyroidism. This study sought to determine the incidence of postlobectomy thyroid hormone replacement as well as predictive risk factors to better counsel patients. Study Design Retrospective cohort study. Setting Patients aged 18 t...

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Main Authors: Charles Meyer MD, Danielle Anderson DO, Zhiqiao Dong, Jeanelle Braxton Riddick MPA, Marilisa Elrod MD, PhD, Marco Ayala MD
Format: Article
Language:English
Published: SAGE Publishing 2021-02-01
Series:OTO Open
Online Access:https://doi.org/10.1177/2473974X21992001
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spelling doaj-0c0fa864cdf04e89b1fe88adcbb2335e2021-02-17T02:03:53ZengSAGE PublishingOTO Open2473-974X2021-02-01510.1177/2473974X21992001Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective StudyCharles Meyer MD0Danielle Anderson DO1Zhiqiao Dong2Jeanelle Braxton Riddick MPA3Marilisa Elrod MD, PhD4Marco Ayala MD5Department of Otolaryngology–Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USADepartment of Otolaryngology–Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USADepartment of Otolaryngology–Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USADepartment of Otolaryngology–Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USADepartment of Pediatrics, Naval Medical Center Portsmouth, Portsmouth, Virginia, USADepartment of Otolaryngology–Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USAObjective Following thyroid lobectomy, patients are at risk for hypothyroidism. This study sought to determine the incidence of postlobectomy thyroid hormone replacement as well as predictive risk factors to better counsel patients. Study Design Retrospective cohort study. Setting Patients aged 18 to 75 years treated in a single academic institution who underwent thyroid lobectomy from October 2006 to September 2017. Methods Patients were followed for an average of 73 months. Demographic data, body mass index, size of removed and remnant lobe, preoperative thyroid-stimulating hormone (TSH) level, final thyroid pathology, and presence of thyroiditis were collected and analyzed. Risk factors were evaluated with chi-square analyses, t tests, logistic regression, and Kaplan-Meier analysis. Results Of the 478 patients reviewed, 369 were included in the analysis, 30% of whom eventually required thyroid hormone replacement. More than 39% started therapy >12 months postoperatively, with 90% treated within 36 months. Patient age ≥50 years and preoperative TSH ≥2.5 mIU/L were associated with odds ratios of 2.034 and 3.827, respectively, for thyroid hormone replacement. Malignancy on final pathology demonstrated an odds ratio of 7.76 for hormone replacement. Sex, body mass index, volume of resected and remaining lobes, and weight of resected lobe were not significant predictors. Conclusion Nearly a third of patients may ultimately require thyroid hormone replacement. Age at the time of surgery, preoperative TSH, and final pathology are strong, clinically relevant predictors of the need for future thyroid hormone replacement. After lobectomy, patients should have long-term thyroid function follow-up to monitor for delayed hypothyroidism.https://doi.org/10.1177/2473974X21992001
collection DOAJ
language English
format Article
sources DOAJ
author Charles Meyer MD
Danielle Anderson DO
Zhiqiao Dong
Jeanelle Braxton Riddick MPA
Marilisa Elrod MD, PhD
Marco Ayala MD
spellingShingle Charles Meyer MD
Danielle Anderson DO
Zhiqiao Dong
Jeanelle Braxton Riddick MPA
Marilisa Elrod MD, PhD
Marco Ayala MD
Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study
OTO Open
author_facet Charles Meyer MD
Danielle Anderson DO
Zhiqiao Dong
Jeanelle Braxton Riddick MPA
Marilisa Elrod MD, PhD
Marco Ayala MD
author_sort Charles Meyer MD
title Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study
title_short Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study
title_full Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study
title_fullStr Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study
title_full_unstemmed Prediction of Thyroid Hormone Replacement Following Thyroid Lobectomy: A Long-term Retrospective Study
title_sort prediction of thyroid hormone replacement following thyroid lobectomy: a long-term retrospective study
publisher SAGE Publishing
series OTO Open
issn 2473-974X
publishDate 2021-02-01
description Objective Following thyroid lobectomy, patients are at risk for hypothyroidism. This study sought to determine the incidence of postlobectomy thyroid hormone replacement as well as predictive risk factors to better counsel patients. Study Design Retrospective cohort study. Setting Patients aged 18 to 75 years treated in a single academic institution who underwent thyroid lobectomy from October 2006 to September 2017. Methods Patients were followed for an average of 73 months. Demographic data, body mass index, size of removed and remnant lobe, preoperative thyroid-stimulating hormone (TSH) level, final thyroid pathology, and presence of thyroiditis were collected and analyzed. Risk factors were evaluated with chi-square analyses, t tests, logistic regression, and Kaplan-Meier analysis. Results Of the 478 patients reviewed, 369 were included in the analysis, 30% of whom eventually required thyroid hormone replacement. More than 39% started therapy >12 months postoperatively, with 90% treated within 36 months. Patient age ≥50 years and preoperative TSH ≥2.5 mIU/L were associated with odds ratios of 2.034 and 3.827, respectively, for thyroid hormone replacement. Malignancy on final pathology demonstrated an odds ratio of 7.76 for hormone replacement. Sex, body mass index, volume of resected and remaining lobes, and weight of resected lobe were not significant predictors. Conclusion Nearly a third of patients may ultimately require thyroid hormone replacement. Age at the time of surgery, preoperative TSH, and final pathology are strong, clinically relevant predictors of the need for future thyroid hormone replacement. After lobectomy, patients should have long-term thyroid function follow-up to monitor for delayed hypothyroidism.
url https://doi.org/10.1177/2473974X21992001
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