INCIDENCE AND RISK FACTORS FOR EARLY SUPPLEMENTATION THERAPY AFTER HEMITHYROIDECTOMY FOR BENIGN CONDITIONS IN EUROPE

AUTHORS:
J. Villar del Moral (Granada, Spain) , J.I. Arcelus Martínez (Granada, Spain) , A. Becerra Massare (Granada, Spain) , N. Muñoz Pérez (Granada, Spain) , M. Arteaga Ledesma (Granada, Spain) , C. Acosta Gallardo (Granada, Spain) , M.C. Mohamed Hassin (Granada, Spain) , M.C. Olvera Porcel (Granada, Spain) , C. Martínez Santos (Marbella, Spain)
Background:
The incidence and risk factors of hypothyroidism after hemithyroidectomy (HT) remain poorly defined. Regarding its treatment, national or local policies can influence on early (first-visit) prescription of replacement therapy (EPRT). Our aim was to know EPRT rates after HT in Europe and what factors can impact on this decision.
Methods:
Retrospective multicentric Eurocrine©-based study focused on patients undergoing HT. Exclusion criteria: cancer in pathological report, and posterior completion thyroidectomy. Analyzed variables include the country and epidemiological, clinical, surgical, pathological and follow-up data. Dependent variable was EPRT or not at first visit, 30-45 days after surgery. The relationship among qualitative variables and the likelihood to receive EPRT were tested with Chi-square or Fisher tests. A predictive multivariate logistic regression model for relevant independent variables was used.
Results:
13,606 patients undergoing HT due to benign conditions between 2015 and 2022 were included. Median age was 52.5 years, and 78% were females. The most frequent indications were excluding malignancy (55%) and compressive symptoms (37%). Overall, 4,580 (33.6%) received EPRT, with a large variability among countries, ranging from 8.6 to 97%. Emerging risk factors for EPRT from multivariate model included younger age, malignancy and thyreotoxicosis as surgical indications, Bethesda III as cytology results, a shorter operation time, a heavier surgical specimen, thyroiditis in pathological report, and country where HT was done.
Conclusions:
One third of patients undergoing HT needed EPRT. That prescription is more prone facing younger patients, malignancy and thyreotoxicosis as surgical indications, Bethesda III cytology, and thyroiditis in pathological report. In addition to that features, also country matters.