Predictive Factors for Thyroid Hormone Supplementation Following Hemithyroidectomy

Authors

Naglaa F. Amer, General Surgery Department, Faculty of medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt
Abd Elaziz A. Taalab, General Surgery Department, Faculty of medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt
Hady S. Abou Ashour, General Surgery Department, Faculty of medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt
Tarek S. Fathalla, General Surgery Department, Shebin Elkom teaching hospital, Shebin Elkom, Menoufia, EgyptFollow
Ahmed S. Mashal, General Surgery Department, Faculty of medicine, Menoufia University, Shebin Elkom, Menoufia, Egypt

Abstract

Objectives To identify predictive factors associated with the need for thyroid hormone supplementation following hemithyroidectomy. Background Thyroid nodules are prevalent, with a significant proportion being benign. Thyroid lobectomy is a common treatment, aiming to avoid complications associated with total thyroidectomy. However, there is variability in the incidence of postoperative hypothyroidism and the need for hormone replacement, complicating patient management. Methods This prospective cohort study was conducted at Menoufia University Hospital from May 2023 to May 2024, including 78 patients undergoing hemithyroidectomy. Data collected included demographic details, preoperative TSH levels, thyroid antibodies, and postoperative outcomes. Predictive factors for thyroid hormone supplementation were analyzed using univariate and multivariate logistic regression. Results Among 78 patients, 25 required postoperative thyroid hormone supplementation. These patients were older (mean age 48.7 vs. 39.5 years, p < 0.01) and had higher preoperative TSH levels (mean 3.2 vs. 1.8 mIU/L, p < 0.001). Presence of malignancy (OR 3.0, p < 0.001) was significant predictors. After six weeks, 92% of those needing supplementation had symptoms like fatigue and cold intolerance. Logistic regression confirmed older age (OR 1.07 per year), high preoperative TSH (OR 3.1), and malignancy (OR 2.8) as key predictors. Kaplan-Meier analysis showed a higher risk for patients with TSH >2.5 mIU/L and positive microsomal antibodies (66.7%). Conclusions Older age, elevated preoperative TSH levels, and malignancy are significant predictors of the need for postoperative thyroid hormone supplementation following hemithyroidectomy.

Subject Area

Surgery

Article Type

Original Study

Recommended Citation

Amer, Naglaa F.; Taalab, Abd Elaziz A.; Ashour, Hady S. Abou; Fathalla, Tarek S.; and Mashal, Ahmed S. (2025) "Predictive Factors for Thyroid Hormone Supplementation Following Hemithyroidectomy," Menoufia Medical Journal: Vol. 38: Iss. 1, Article 22.
DOI: https://doi.org/10.59204/2314-6788.3328

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