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Quality of life (QoL) in patients with benign thyroid goiters (pre- and post-thyroidectomy): a prospective study
Anjali Mishra1, Mayilvaganan Sabaretnam, Gyan Chand
1Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, India. anjali@sgpgi.ac.in
Background:
Preservation of quality of life (QoL) seems an important therapeutic goal in patients with benign thyroid diseases. The aim of the present study was to investigate the impact of thyroidectomy on QoL in patients with benign goiters and to assess the significance of various factors affecting the outcome.
Methods:
A prospective study consisting of 100 patients with benign goiters was conducted between November 2009 and March 2011. Patients completed a disease-specific ThyPRO questionnaire to assess QoL before and 6 months after thyroidectomy. Preoperative and postoperative scores were compared; and univariate and multivariate analyses were performed.
Results:
Mean age of the patients was 40.5 years (M:F = 1:4.3); 82 % of the patients had nodular goiters, and the remaining 18 % had diffuse disease. None of the patients had overt thyroid dysfunction at the time they completed the questionnaire. Operative treatment for 54 % of the patients involved total thyroidectomy, whereas 46 % underwent hemithyroidectomy. None of these patients developed any permanent morbidity following surgery. Mean scores of QoL in the 12 domains examined were low and improved significantly (p < 0.001) after surgery: symptoms, 19.4 versus 0.7; fatigue, 29.5 versus 1.5; vitality, 44.4 versus 3.0; memory and concentration, 25.7 versus 1.5; nervousness, 29.6 versus 1.8; psychological well-being, 33.9 versus 1.3; mood swings, 34.9 versus 0.8; relationship, 15.4 versus 1.4; daily activity, 18.7 versus 1.3; sex life, 20.9 versus 1.7; appearance, 14.7 versus 1.0; and overall, 27 versus 5.5. On univariate analysis, weight of goiter was found to be significantly associated with improvement in the scores of the memory and concentration domain (p = 0.03). On multivariate analysis, factors significantly associated with improvement in different domains were young age (nervousness, p = 0.009), female gender (fatigue, p = 0.02), and weight of goiter (symptoms, p = <0.001; vitality, p = <0.001; and memory and concentration, p = <0.001).
Conclusions:
Patients with benign goiters experience significant improvement in QoL after thyroidectomy.
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