Incidences of Hypothyroidism Associated With Surgical Procedures for Thyroid Disorders: A Nationwide Population-Based Study

Shin-Han Tsai; Shuo-Chen Chien; Phung-Anh Nguyen; Po-Han Chien; Hon-Ping Ma; Rahma Novita Asdary; Yao-Chin Wang; Ayesha Humayun; Chen-Ling Huang; Usman Iqbal; Wen-Shan Jian

doi:10.3389/fphar.2019.01378

Incidences of Hypothyroidism Associated With Surgical Procedures for Thyroid Disorders: A Nationwide Population-Based Study

Front Pharmacol. 2019 Dec 12:10:1378. doi: 10.3389/fphar.2019.01378. eCollection 2019.

Authors

Shin-Han Tsai^{1

2}, Shuo-Chen Chien³, Phung-Anh Nguyen⁴, Po-Han Chien⁵, Hon-Ping Ma^{1

2}, Rahma Novita Asdary⁶, Yao-Chin Wang^{1

3

4

7}, Ayesha Humayun⁸, Chen-Ling Huang⁹, Usman Iqbal^{4

6

8}, Wen-Shan Jian¹⁰

Affiliations

¹ Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
² Emergency Department, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan.
³ Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.
⁴ International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan.
⁵ Department and Graduate Institute of Business Administration, National Taiwan University, Taipei, Taiwan.
⁶ Master Program in Global Health and Development, PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
⁷ Department of Emergency, Min-Sheng General Hospital, Taoyuan, Taiwan.
⁸ Department of Public Health and Community Medicine, Shaikh Khalifa Bin Zayed Al-Nahyan Medical College, Shaikh Zayed Medical Complex, Lahore, Pakistan.
⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
¹⁰ School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.

Abstract

Background and Aim: Limited information available about different types of thyroid surgeries with risk for postoperative hypothyroidism. This study aimed to investigate the risk of developing early and late-onset postoperative hypothyroidism in patients with thyroid disorders. Methods: We used a large cohort data from the Taiwan National Health Insurance Research Data Base (NHIRDB) and identified 9,693 (9, 348) patients from January 1998 to December 2010, admitted for thyroid disorder surgeries. We used the surgical procedures time as the index date. Our observational retrospective cohort study excluded the subjects diagnosed with hypoparathyroidism and hypothyroidism before any surgeries. We analyzed the data using the Cox regression model to calculate the hazard ratio. Result: Postoperative hypothyroidism associated with bilateral-total (HR, 4.27; 95% CI, 3.32-5.50), one-side total and another subtotal (HR, 3.16; 95% CI, 2.59-3.86), bilateral-subtotal (HR, 1.65; 95% CI, 1.37-1.98), and unilateral-total (HR, 1.17; 95% CI, 0.95-1.44) surgical procedures. The time intervals for thyroid disorders were 320 cases developed postoperative hypoparathyroidism in eight weeks, 480 cases the second month, and 1000 cases in the first year after surgery. Conclusion: Findings suggest that thyroidectomy was associated with transient postoperative hypothyroidism in thyroid disorder patients. The bilateral-total surgical procedure was strongly associated with temporary postoperative hypothyroidism.

Keywords: BigData analytics; hormones; postoperative hypothyroidism; surgeons experience; thyroid disorders; thyroid surgeries; transient hypothyroidism.