Surgery to remove all or part of the thyroid can trigger side effects that send some patients back to the hospital, a new study finds.
These side effects include tingling in the fingers that can become tremors and spasms in all muscles of the body — including the heart and muscles surrounding the lungs.
“The information we gleaned is directly applicable to patient care, and suggests more careful immediate follow-up for patients at high risk for side effects and complications of surgery,” said study author Dr. Alliric Willis. He is co-director of the Jefferson Thyroid and Parathyroid Center of Thomas Jefferson University in Philadelphia.
Removing the thyroid is usually a safe procedure. However, some of the side effects of the operation can be so severe that patients need to be hospitalized, Willis explained in a university news release.
For the study, the researchers used the 2014 Nationwide Readmissions Database to collect data on nearly 23,000 patients who had thyroid surgery. The procedures were done to cure cancer, treat goiter (an enlarged thyroid), or manage an overactive thyroid.
In all, 4 percent were hospitalized again within 30 days. Most of these patients were readmitted within a week after surgery. Of the patients that needed readmission, 25 percent returned within two days, the researchers found.
“Although 4 percent is less than estimates from earlier, smaller studies, it still amounts to nearly 1,000 patients per year whose symptoms are severe enough to seek immediate medical attention and need admission to the hospital,” said first author Dr. Arturo Rios-Diaz, a surgical resident at Thomas Jefferson University.
The researchers found that those at the highest risk of being hospitalized were those with Medicare and Medicaid. Also at risk were patients who had low calcium levels after surgery and those who remained in the hospital two days or more after surgery.
Low calcium levels, or hypocalcemia, is the most common side effect and is usually caused by damage to or removal of the parathyroid glands. The condition can be treated with calcium pills.
“Although the standard treatment for hypocalcemia is simple, patients have to be able to get their medications after discharge from their surgery,” Willis said.
“Patients on Medicaid and Medicare could find it financially or logistically difficult to obtain the treatment before the symptoms begin and worsen,” he suggested.
Willis said patients should be checked on by phone in the first days after leaving the hospital, when they have the greatest risk for complications.
The report was published Jan. 3 in the journal Surgery.
Visit the American Thyroid Association for more on thyroid surgery.
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