Post-thyroidectomy hematoma and hypocalcemia as separate complications: risk factors and management—a systematic review and meta-analysis
Notice bibliographique
Résumé
Background: Thyroidectomy is a common surgical procedure for various thyroid conditions, including benign nodules, multinodular goiters, hyperthyroidism, and malignancies. Despite its widespread use, it is associated with significant complications such as post-thyroidectomy hematoma and hypocalcemia. This systematic review aims to evaluate the risk factors and management strategies for these complications to enhance patient outcomes. Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across multiple electronic databases, including Scopus, Cochrane Library, Web of Science, PubMed, and ScienceDirect, using keywords related to post-thyroidectomy hematoma and hypocalcemia. Only studies published between 2010 and 2024 were considered. Studies were included if they focused on adult patients undergoing thyroidectomy and reported on the incidence or management of these complications. Studies were excluded if they were letters to the editor, case reports, opinion pieces, non-peer-reviewed articles or not in English. Pooled rates for hematoma and hypocalcemia were calculated using R software. A random-effects model was used to address study heterogeneity and calculate the pooled incidence estimate. The Newcastle-Ottawa Scale (NOS) was used to assess bias and select high-quality studies, improving the reliability of the results. Results: The present study identified 10 studies meeting the inclusion criteria (253,941 participants), with most scoring 9/9 on the NOS. The meta-analysis revealed that the pooled incidence of post-thyroidectomy hematoma is approximately 1.43% [95% confidence interval (CI): 1.07% to 1.80%, P<0.001], with significant heterogeneity across studies (I2=88.01%, P<0.001). Notable risk factors include older age, vitamin D deficiency, and thyroid malignancy. For hypocalcemia, the pooled incidence is around 23.14% (95% CI: 10.96% to 35.32%, P<0.001), also showing substantial heterogeneity (I2=99.97%, P<0.001). Risk factors included older age, female sex, malignancy, total thyroidectomy, and Graves’ disease. Effective management strategies for hematoma included reoperation and tracheostomy, while for hypocalcemia, calcium and vitamin D supplementation and intravenous calcium were critical. Conclusions: Post-thyroidectomy hematoma and hypocalcemia are major complications that affect patient outcomes and increase healthcare costs. Identifying risk factors and applying effective surgical and postoperative strategies can help reduce these risks.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,008 | 0,002 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».