Assessment of Inter-Institutional Post-Operative Hypoparathyroidism Status Using a Common Data Model

Area of Science:

• Endocrinology
• Surgical Oncology
• Health Informatics

Background:

• Post-thyroidectomy hypoparathyroidism presents with diverse symptoms, from mild paresthesia to severe respiratory distress.
• Accurate incidence rates and contributing factors for post-thyroidectomy hypoparathyroidism remain challenging to ascertain due to variations in surgical practices and institutional data.
• The Observational Health Data Sciences and Informatics (OHDSI) Common Data Model (CDM) offers a standardized framework for integrating and analyzing data from multiple institutions.

Purpose of the Study:

• To estimate the incidence of post-operative hypoparathyroidism following thyroidectomy.
• To identify surgical factors associated with an increased likelihood of developing transient or permanent hypoparathyroidism.
• To leverage the OHDSI CDM for robust analysis of real-world data from multiple tertiary care centers.

Main Methods:

• Retrospective analysis of electronic health records from two tertiary institutions utilizing the OHDSI CDM.
• Extraction of patient data, including thyroidectomy types and post-operative hypoparathyroidism diagnoses, between January 2013 and December 2018.
• Logistic regression models (univariate and multivariate) were employed to assess the association between operation type and hypoparathyroidism occurrence.

Main Results:

• Out of 4848 thyroidectomy patients, 1370 (28.26%) experienced transient hypoparathyroidism and 251 (5.18%) experienced permanent hypoparathyroidism.
• Radical tumor resection was significantly associated with a higher likelihood of both transient (48% increased odds) and permanent (102% increased odds) hypoparathyroidism compared to total bilateral thyroidectomy.
• Multivariate analysis confirmed radical tumor resection's association with increased odds of transient (50%) and permanent (97%) hypoparathyroidism.

Conclusions:

• Thyroidectomy carries a notable risk of both transient and permanent hypoparathyroidism, with specific procedures like radical tumor resection posing a significantly higher risk.
• The OHDSI CDM facilitates the integration of data from disparate institutions, enabling more reliable estimations of post-operative complication incidence and associated risk factors.
• Future research should expand this analysis to larger, multi-institutional datasets adhering to the OHDSI protocol to further refine understanding of post-thyroidectomy hypoparathyroidism.