Early prediction of hypocalcemia following thyroid surgery. A prospective randomized clinical trial

Abstract

According to our previous study, the combined measurement of iPTH 6 h after surgery and of serum calcium 24 h after surgery are highly predictive of early postoperative hypocalcemia. These results are important in selecting the patients eligible for early discharge and those who need calcium and vitamin D supplementation.

Postoperative day 1 levels of parathyroid as predictor of occurrence and severity of hypocalcaemia after total thyroidectomy

“…A postoperative decline in PTH of more than 37.9%‐88% compared with preoperative levels had a sensitivity ranging from 70%‐100% for predicting transient hypocalcaemia. More recently, focus has been given on intraoperative and early postoperative measurements of PTH . The efficacy of 24‐hour PTH has also been confirmed in a few recent retrospective series .…”

“…Postoperative PTH serum levels may accurately predict occurrence as well as severity of hypocalcaemia after thyroidectomy . Numerous studies have utilized either absolute values or relative percentage decrease of PTH for diagnosis .…”

“…Numerous studies have utilized either absolute values or relative percentage decrease of PTH for diagnosis . In addition, timing for PTH measurements varies significantly among studies, ranging from intraoperative measurements to measurements in the early postoperative period (generally 1‐4 hours after surgery) up to 24 hours postoperatively . In almost all of these settings, PTH has been found to be a reliable early marker for postoperative hypoparathyroidism .…”

“…Postoperative PTH serum levels may accurately predict occurrence as well as severity of hypocalcaemia after thyroidectomy. [17][18][19][20][21][22][23][24][25][26] Numerous studies have utilized either absolute values or relative percentage decrease of PTH for diagnosis. 20,[27][28][29][30][31][32] In addition, timing for PTH measurements varies significantly among studies, ranging from intraoperative measurements to measurements in the early postoperative period (generally 1-4 hours after surgery) up to 24 hours postoperatively.…”

“…20,[27][28][29][30][31][32] In addition, timing for PTH measurements varies significantly among studies, ranging from intraoperative measurements to measurements in the early postoperative period (generally 1-4 hours after surgery) up to 24 hours postoperatively. [12][13][14][15][16][17]23,24 In almost all of these settings, PTH has been found to be a reliable early marker for postoperative hypoparathyroidism. [12][13][14][15][16][17]20,23,24,[27][28][29][30][31][32] In 2014, a large metaanalysis provided evidence that lower postoperative PTH levels 30 minutes to 5 days after surgery are associated with transient hypocalcaemia.…”