Effectiveness of an i-PTH Measurement in Predicting Post Thyroidectomy Hypocalcemia: Prospective Controlled Study.
10.3349/ymj.2013.54.3.637
- Author:
Jin Pyeong KIM
1
;
Jung Je PARK
;
Hee Young SON
;
Rock Bum KIM
;
Ho Youp KIM
;
Seung Hoon WOO
Author Information
1. Department of Otorhinolaryngology, Gyeongsang National University, Jinju, Korea. lesaby@hanmail.net
- Publication Type:Original Article
- Keywords:
Thyroidectomy;
hypocalcemia;
parathyroid hormone;
surgery
- MeSH:
Calcium/blood;
Humans;
Hypocalcemia/*diagnosis;
Magnesium/blood;
Odds Ratio;
Parathyroid Hormone/*blood;
Phosphates/blood;
Postoperative Complications/blood/*diagnosis;
Prospective Studies;
Serum Albumin;
Thyroidectomy/*adverse effects
- From:Yonsei Medical Journal
2013;54(3):637-642
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. MATERIALS AND METHODS: We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. RESULTS: 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. CONCLUSION: We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy.
