Evaluation of Perioperative Serum Parathyroid Hormone Levels in Predicting Post-thyroidectomy Hypocalcemia.
- Author:
Ho Young JANG
1
;
Ji A KIM
;
Won Ho KIL
;
Young Jin CHOI
;
Sang Uk WOO
;
Jeong Han KIM
;
Seok Jin NAM
;
Jung Hyun YANG
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhkim@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Hypocalcemia;
Parathyroid hormone;
Thyroidectomy
- MeSH:
Calcium;
Humans;
Hypocalcemia*;
Incidence;
Length of Stay;
Parathyroid Hormone*;
Thyroid Gland;
Thyroidectomy
- From:Journal of the Korean Surgical Society
2006;71(4):250-255
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Postoperative hypocalcemia is one of the most common complications in patients who undergo a bilateral thyroid resection and can prolong hospital stay. However, there is no reliable predictor of clinical hypocalcemia after a thyroidectomy. The aim of this study was to identify the clinical predictors of hypocalcemia after a thyroidectomy and to determine if the perioperative measurements of iPTH would be helpful in identifying patients at risk of post-thyroidectomy hypocalcemia. METHODS: 213 consecutive patients undergoing thyroidectomy between Nov 2004 and Feb 2005 were examined. The iPTH, serum calcium and ionized calcium levels were measured at 6 hours, 1 day and 2 weeks after surgery, respectively. All the patients were divided into the lower PTH group (<10 pg/ml) and normal PTH group according to the level of iPTH measured at 6 hours after surgery. RESULTS: The lower PTH group comprised 33% of all patients: 39% after the total thyroidectomy and 11% after a less than total thyroidectomy. The incidence of IV calcium replacement was 36% in the lower PTH group compared with 13% in the normal PTH group. Hypocalcemia and a lowered PTH level occurred more frequently in patients who underwent surgery for a malignant tumor than for a benign tumor. CONCLUSION: There was a correlation between the level of ionized calcium and the incidence of calcium replacement and with the 6 hr-later iPTH level. Therefore, a iPTH leve
