Complicações de longo prazo e manifestações do hipoparatireoidismo pós-cirúrgico permanente em pacientes idosos: uma revisão de escopo

Resumo

Justification and objectives: About 75% of all cases of hypoparathyroidism (HypoPT) occur after neck surgery. Clinical features of chronic hypocalcemia and long-term complications characterize the permanent disease. Although 71 to 88% of cases of postoperative HypoPT (PO-HypoPT) occur in the fifth decade of life, there is lack of data in older population. Content: We included cohorts, case-controls or case-series studies that evaluated POHypoPT in adults above 60 years-old. Using the terms “hypocalcemia” or “hypoparathyroidism” AND “aged” or “elderly” or “aged, 80 and over” or “oldest old”, 2024 articles were found in the electronic search in MEDLINE and EMBASE database. Two independent authors reviewed the articles. Conclusions: Only one study met this review’s criteria, a cohort with 322 patients with HypoPT. In this study, creatinine clearance <60mL/ minute/1.73m2 was significantly associated with age (p<0.0001), with 95.5% of patients with more than 60 years-old having renal insufficiency (a 2.9-fold more risk for renal impairment when compared to younger ages). The major feature to be specifically addressed in older patients with PO-HypoPT is creatinine clearance calculation, although it would be recommended searching for signs and symptoms of hypocalcemia, as well as for macrovascular impairment and psychiatric involvement. Openscience Framework systematic review registration: 10.17605/OSF.IO/AM2KY