Risk factors for hypothyroidism following hemithyroidectomy

Objective: Hypothyroidism is the most common complication of hemithyroidectomy for thyroid nodules. This retrospective cohort study investigated the prognostic factors for hypothyroidism following hemithyroidectomy. Methods: We included patients who underwent hemithyroidectomy between 2016 and 2017, excluding those with history of preoperative hypothyroidism or malignancy on histopathological examination. The primary endpoint was development of hypothyroidism during follow-up (TSH >= 2 above normal). Results: Twenty-six of the 128 included patients (20%) developed postoperative hypothyroidism. The following independent prognostic factors were found: preoperative TSH level > 1.5 mIU/L (OR 2.11; P = 0.013), and remaining thyroid volume adjusted for body surface area <4.0 mL/m(2) (OR 1.77; P = 0.015). Twenty-one patients (81%) had first TSH values above the upper limit of normal. Postoperatively, first TSH level correlated significantly with the preoperative value (R = 0.5779, P < 0.001). Levothyroxine was prescribed to 16% of patients, with a mean dose of 0.92 mu g/kg/day. Conclusion: Patients with TSH > 1.5 mIU/or remaining thyroid volume adjusted for body surface area < 4.0 mL/m(2) should have intensified clinical and biological follow-up in the first year after surgery.(c) 2023 Elsevier Masson SAS. All rights reserved.