title: The prevalence of post-thyroidectomy chronic asthenia: a prospective cohort study.
abstract: OBJECTIVE
  Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors.
  
  
  METHODS
  A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre- and post-operative thyroid hormone levels, and BMI outside the normal range. Demographics; smoking and alcoholism addiction; cardiac, pulmonary, renal, and hepatic failure; diabetes; anxiety; and depression were recorded. The Brief Fatigue Inventory (BFI) was used to evaluate CA and its possible association with these comorbidities 6 and 12 months after thyroidectomy.
  
  
  RESULTS
  One hundred seventy-seven patients underwent total thyroidectomy (TT), 54 hemithyroidectomy (HT). Thirty-two patients were not recorded because of the onset of exclusion criteria. In the 6 months after thyroidectomy, in the TT group, 64 patients (36.16%) reported an impairment in the BFI score and only 1 in the TL group. The mean BFI score changed from 1.663(±1.191) to 2.16 (±11.148) in the TT group, from 1.584 (±1.371) to 1.171 (±1.093) in the TL group (p < 0.001). No further significant variations in BFI were reported 1 year after surgery.
  
  
  CONCLUSIONS
  CA worsened after TT, but not after HT. Apart from operative procedure itself, no other risk factor was found be significantly associated with post-thyroidectomy asthenia. Further investigation is needed to determine the causes of CA.
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Gregorio
authors.initials: G
authors.lastname: Scerrino
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy. irene_melfa@yahoo.it.
authors.forename: Giuseppina
authors.identifier: http://orcid.org/0000-0002-9439-3073
authors.initials: G
authors.lastname: Melfa
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Raspanti
authors.affiliation: Unit of General and Thoracic Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Attard
authors.affiliation: Unit of Clinical Epidemiology and Tumor Registry, Department of Laboratory Diagnostics, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Mazzola
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gullo
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Bonventre
authors.affiliation: Unit of Endocrinology, Department of Medicine, "V. Cervello Hospital," Palermo, Via Trabucco 180, 90100, Palermo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Attard
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cocorullo
authors.affiliation: Unit of General and Emergency Surgery, Department of General, Emergency and Transplant Surgery, Policlinico "P. Giaccone", University of Palermo, Via L. Giuffré 5, 90100, Palermo, Italy.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Gulotta
mesh_terms: D000328:Adult; D000368:Aged; D001247:Asthenia / Q000453:epidemiology*; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Chronic asthenia; Fatigue; Hemithyroidectomy; Total thyroidectomy