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Hipocalcemia post- tiroidectomía total: análisis de dosis para suplemento rutinario profiláctico
dc.rights.license | Atribución-NoComercial-SinDerivadas 4.0 Internacional |
dc.contributor.advisor | Zúñiga Pavia, Sergio Fabián |
dc.contributor.author | Gómez Gutiérrez, Carlos Andrés |
dc.date.accessioned | 2022-03-03T21:35:21Z |
dc.date.available | 2022-03-03T21:35:21Z |
dc.date.issued | 2022 |
dc.identifier.uri | https://repositorio.unal.edu.co/handle/unal/81127 |
dc.description | ilustraciones, tablas |
dc.description.abstract | Introducción. La hipocalcemia es la complicación más frecuente de la tiroidectomía. La profilaxis con calcio/ calcitriol es una alternativa costo-efectiva, sencilla y expedita para disminuir esta situación, sin alterar la función paratiroidea residual. Lo que no está claro es si hay superioridad de una dosis frente a otra, por lo que el objetivo de este estudio fue evaluar el comportamiento entre diferentes esquemas de profilaxis para hipocalcemia. Métodos. Estudio de cohorte retrospectivo de adultos operados en un hospital de cuarto nivel, entre febrero de 2017 y diciembre de 2020. Se calculó la tasa de síntomas, la hipocalcemia e hipercalcemia bioquímica en el control postquirúrgico durante las siguientes dos semanas. Se hizo análisis bivariado y multivariado entre dosis de calcio/ calcitriol, otros factores asociados y los desenlaces mencionados. Resultados. Se incluyeron 967 pacientes. El 10 % presentaron síntomas. No hubo diferencias significativas en el calcio sérico del control posquirúrgico entre los grupos con distintas dosis de calcio. La dosis de carbonato de calcio >3600 mg/día y el calcio en las primeras 24 horas de cirugía se asociaron a la presencia de síntomas. La dosis de calcitriol <1 mcg/día y el bocio aumentaron el riesgo de hipocalcemia bioquímica, mientras que la dosis de 1,5 mcg/día lo disminuyó. Ninguna variable evaluada se asoció a hipercalcemia bioquímica. Conclusiones: Podemos establecer que dosis altas de carbonato de calcio no se asocian menos a hipocalcemia bioquímica, lo cual está a favor de usar dosis intermedias (i.e. 3600mg/día). De forma similar, la dosis de calcitriol de 1.5mcg/día disminuye el riesgo de este desenlace. La identificación de variables que aumentan o disminuyen el riesgo de esta complicación (bocio o el calcio en las primeras 24 horas para este estudio) pueden determinar ajustes individuales en la dosis rutinaria profiláctica de calcio/calcitriol. (Texto tomado de la fuente). |
dc.description.abstract | Introduction. Hypocalcemia is the most frequent complication of thyroidectomy. Calcium/calcitriol prophylaxis is a cost-effective, simple and expeditious alternative to reduce this situation, without altering residual parathyroid function. It is not clear whether there is superiority of one dose over another, so the objective of this study was to evaluate the behavior between prophylaxis doses for hypocalcemia. Methods. Retrospective cohort study of adults operated in a fourth level hospital, between February 2017 and December 2020. The rate of symptoms, biochemical hypocalcemia and hypercalcemia was calculated in the post surgical control during the following two weeks. Bivariate and multivariate analyses were performed between calcium/calcitriol dose, other associated factors, and the mentioned outcomes. Results. Out of the 967 patients included, 10% presented symptoms. There were no significant differences in postoperative control serum calcium between the groups with different doses of calcium. The dose of calcium carbonate > 3600 mg/day and calcium in the first 24 hours of surgery were associated with the presence of symptoms. The dose of calcitriol <1 mcg/day and goiter increased the risk of biochemical hypocalcemia, while the dose of 1.5 mcg / day decreased it. No variable evaluated was associated with biochemical hypercalcemia. Conclusions: We can establish that high doses of calcium are not less associated with biochemical hypocalcemia, which is in favor of intermediate doses (i.e. 3600mg/day). In a similar way, the calcitriol dose of 1.5mcg/day decreases the risk of this outcome. The identification of variables that increase or decrease the risk of this complication (goiter or the 24h serum calcium in this study) can decide settings in the rutinary prophylactic dose of calcium/calcitriol |
dc.format.extent | 41 páginas |
dc.format.mimetype | application/pdf |
dc.language.iso | spa |
dc.publisher | Universidad Nacional de Colombia |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
dc.subject.ddc | 610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología |
dc.title | Hipocalcemia post- tiroidectomía total: análisis de dosis para suplemento rutinario profiláctico |
dc.type | Trabajo de grado - Especialidad Médica |
dc.type.driver | info:eu-repo/semantics/masterThesis |
dc.type.version | info:eu-repo/semantics/acceptedVersion |
dc.publisher.program | Bogotá - Medicina - Especialidad en Cirugía General |
dc.description.degreelevel | Especialidades Médicas |
dc.description.degreename | Especialista en Cirugía General |
dc.identifier.instname | Universidad Nacional de Colombia |
dc.identifier.reponame | Repositorio Institucional Universidad Nacional de Colombia |
dc.identifier.repourl | https://repositorio.unal.edu.co/ |
dc.publisher.department | Departamento de Cirugía |
dc.publisher.faculty | Facultad de Medicina |
dc.publisher.place | Bogotá, Colombia |
dc.publisher.branch | Universidad Nacional de Colombia - Sede Bogotá |
dc.relation.indexed | Bireme |
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dc.rights.accessrights | info:eu-repo/semantics/openAccess |
dc.subject.decs | Hipocalcemia |
dc.subject.decs | Hypocalcemia |
dc.subject.decs | Thyroidectomy/rehabilitation |
dc.subject.decs | Tiroidectomía/rehabilitación |
dc.subject.decs | Prevención de Enfermedades |
dc.subject.decs | Disease Prevention |
dc.subject.proposal | Thyroidectomy |
dc.subject.proposal | Tiroidectomía |
dc.subject.proposal | Hipocalcemia |
dc.subject.proposal | Carbonato de calcio |
dc.subject.proposal | Calcitriol |
dc.subject.proposal | Hipercalcemia |
dc.subject.proposal | Hypocalcemia |
dc.subject.proposal | Calcium carbonate |
dc.subject.proposal | Calcitriol |
dc.subject.proposal | Hypercalcemia |
dc.title.translated | Hypocalcemia following total thyroidectomy: an analysis of dose for prophylactic routinary substitution |
dc.type.coar | http://purl.org/coar/resource_type/c_bdcc |
dc.type.coarversion | http://purl.org/coar/version/c_ab4af688f83e57aa |
dc.type.content | Text |
dc.type.redcol | http://purl.org/redcol/resource_type/TM |
oaire.accessrights | http://purl.org/coar/access_right/c_abf2 |
dcterms.audience.professionaldevelopment | Público general |
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