Surgical Treatment of Hyperthyroidism Can Be Performed Safely Before a Euthyroid State is Achieved
Authors' conclusion
Our results affirm that thyroidectomy in actively thyrotoxic patients is safe and will not precipitate thyroid storm.
Study context
- Population
- Hyperthyroidism patients (diagnosis with at least one suppressed TSH) undergoing thyroidectomy, single institution, December 2015 to November 2022; 84.3% women, 51.3% uncontrolled at surgery
- Participants
- 275 patients
- Exposure
- Uncontrolled vs controlled hyperthyroidism at time of thyroidectomy
- Outcome
- Thyroid storm precipitated by surgery
Methodological detailssingle institution
- Single institution
Main finding
As reported in the abstract
Uncontrolled
0
events
Controlled
0
events
Observational data: associations, not effects.
Further findings
Operative time <1 hour · shorter operative times with Controlled
P < 0.014
Graves' disease diagnosis
P < 0.001
Estimated blood loss
P = 0.002
Preoperative TSH
P < 0.001
Preoperative free T4
P < 0.001
| Outcome | Uncontrolled | Controlled | P value |
|---|---|---|---|
| Number of preoperative medications | 2.3 | 1.4 | P < 0.001 |
- Surgery indication: medication intolerance or history of thyroid storm
- P = 0.008
- Surgery indication: medication intolerance or history of thyroid storm: medication intolerance 12.1% vs 6%; history of thyroid storm 6.4% vs 1.5%; more likely with Uncontrolled
Safety
Temporary hypocalcemia · postoperative
P = 0.013
Temporary hypocalcemia · postoperative
- Both groups experienced similar, low rates of other postoperative complications
Original publication
Surgical Treatment of Hyperthyroidism Can Be Performed Safely Before a Euthyroid State is Achieved. Thyroid. Published 30 May 2023. doi:10.
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