1. Effectiveness of an i-PTH Measurement in Predicting Post Thyroidectomy Hypocalcemia: Prospective Controlled Study
- Author
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Seung Hoon Woo, Hee Young Son, Rock Bum Kim, Jin Pyeong Kim, Jung Je Park, and Ho Youp Kim
- Subjects
medicine.medical_specialty ,endocrine system ,PTH measurement ,endocrine system diseases ,medicine.medical_treatment ,Serum albumin ,Urology ,Parathyroid hormone ,Phosphates ,surgery ,Endocrinology & Metabolism ,Postoperative Complications ,Odds Ratio ,Medicine ,Humans ,Magnesium ,Prospective Studies ,Prospective cohort study ,Serum Albumin ,Total thyroidectomy ,biology ,Hypocalcemia ,business.industry ,Thyroidectomy ,nutritional and metabolic diseases ,General Medicine ,Odds ratio ,Surgery ,Parathyroid Hormone ,biology.protein ,Original Article ,Calcium ,business ,Complication ,hormones, hormone substitutes, and hormone antagonists - 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.
- Published
- 2013