The Prognostic Value of Parathyroid Hormone for the Diagnosis of Early Postoperative Hypocalcemia after Thyroidectomy
Abstract
Postoperative hypocalcemia is the most frequent complication after thyroidectomy. One goal of our study was to investigate the parathyroid hormone (PTH) as the main predictor and early postoperative hypocalcemia. The study prospectively included 135 patients who from October 2011 to May 2013 was performed thyroidectomy. According to the results according to logistic regression analysis, postoperative PTH level below 10 pg/ml was the main predictor of postoperative hypocalcemia ( p <0,001). Sensitivity, specificity, positive and negative predictive value of PTH <10 pg / ml for predicting postoperative hypocalcemia were 71%, 99%, 97% and 86%, respectively. It can be concluded that measurement of PTH after 1 hour, and / or on the following day after thyroidectomy hypocalcemia predicts with high sensitivity, specificity. And early detection of PTH allows timely appoint agents calcium and vitamin D to prevent clinical manifestations of postoperative hypoparathyroidism.
About the Authors
O V SimakinaEndocrinology Research Centre
N V Latkina
Endocrinology Research Centre
I V Kim
Endocrinology Research Centre
N S Kuznetsov
Endocrinology Research Centre
References
1. Bergamaschi R, Becouarn G, Ronceray J, Arnaud JP. Morbidity of thyroid surgery. Am J Surg. 1998;176(1):71675.
2. Bhattacharyya N, Fried MP. Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngol Head Neck Surg. 2002;128(4):3896392.
3. Thomusch O, Machens A, Sekulla C et al. Multivariate analy6 sis of risk factors for postoperative complications in benign goiter surgery: prospective multi6center study in Germany. World J Surg. 2000;24(11):133561341.
4. Abboud B, Sargi Z, Akkam M, Sleilaty F. Risk factors for post6 thyroidectomy hypocalcemia. J Am Coll Surg. 2002;195(4): 4566461.
5. Kikuchi S, Perrier ND, Cheah WK et al. Complication of thy6 roidectomy in patients with radiation6induced thyroid neo6 plasms. Arch Surg. 2004;139(11):118561188.
6. Cavicchi O, Piccin O, Caliceti U et al. Transient hypoparathy6 roidism following thyroidectomy: a prospective study and multivariate analysis of 604 consecutive patients. Otolaryngol Head Neck Surg. 2007;137:6546658.
7. Chapman DB, French CC, Leng X et al. Parathyroid hormone early percent change: an individualized approach to predict postthyroidectomy hypocalcemia. Am J Otolaryngol. 2012; 33:2166220.
8. Hickey L, Gordon CM. Vitamin D deficiency: new perspectives on an old disease. Curr Opin Endocrinol Diabetes. 2004;11(1):18625.
9. Tredici P, Grosso Е, GiBelli B et al. Identification of patients at high risk for hypocalcemia after total thyroidectomy. Acta Otorhinolaryng. Ital. 2010
Review
For citations:
Simakina O.V., Latkina N.V., Kim I.V., Kuznetsov N.S. The Prognostic Value of Parathyroid Hormone for the Diagnosis of Early Postoperative Hypocalcemia after Thyroidectomy. Endocrine Surgery. 2014;8(2):4-8. (In Russ.)
Views:
444
