Benefits Resulting from 1‐and 6‐Hour Parathyroid Hormone and Calcium Levels After Thyroidectomy

Payne, Richard J.; Tewfik, Marc A.; Hier, Michael P.; Tamilia, Michael; Namara, Elizabeth Mac; Young, Jonathan; Black, Martin J.

doi:10.1016/j.otohns.2005.02.021

Cited by 59 publications

(86 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Almost all studies define hypocalcemia as either low serum calcium or development of symptoms of hypocalcemia (9,11,(15)(16)(17)(18)(19)(21)(22)(23)(24)(25)(26). We used only the symptoms of hypocalcemia because we believe that mixing two parameters (biochemical hypocalcemia and symptomatic hypocalcemia) can introduce a bias.…”

Section: Resultsmentioning

confidence: 99%

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Vanderlei

Vieira

Hojaij

et al. 2012

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

Objective: The purpose of this study was to evaluate if the measurement of peri-operative parathyroid hormone (PTH) is able to identify patients with increased risk of developing symptoms of hypocalcemia. Subjects and methods: Forty patients who underwent total thyroidectomy were studied prospectively. Ionized serum calcium and PTH were measured after induction of anesthesia, one hour (PTH1) and one day after surgery (PTH24). Patients were evaluated for symptoms of hypocalcemia and treated with calcium and vitamin D supplementation as necessary. Results: Symptomatic hypocalcemia developed in 16 patients. Symptomatic patients had significant lower PTH1 and greater drops in PTH levels. The selection of 12.1 ng/L as PTH1 level cutoff level divided patients with and without symptoms with 93.7% sensitivity and 91.6% specificity. The selection of 73.5% as the cutoff value for PTH decrease resulted in 91.6% sensitivity and 87.5% specificity. Conclusion: PTH1 levels and the drop in PTH levels are reliable predictors of developing symptomatic hypocalcemia after total thyroidectomy. Arq Bras Endocrinol Metab. 2012;56(3):168-72 Keywords Thyroid gland; PTH; hypocalcemia; thyroidectomy; parathyroid gland RESUMO Objetivo: O objetivo deste estudo é avaliar se a medida perioperatória do hormônio da paratireoide (PTH) pode identificar os pacientes com maior risco de desenvolver sintomas de hipocalcemia. Sujeitos e métodos: Foram estudados quarenta pacientes submetidos à tireo diectomia total. A medida do cálcio sérico e do PTH foi feita após a indução anestésica, uma hora (PTH1) e um dia após a cirurgia. Os pacientes foram avaliados quanto à presença de sintomas de hipocalcemia e tratados com suplementação de cálcio e vitamina D quando necessário. Resultados: Dezesseis pacientes apresentaram sintomas de hipocalcemia. Os pacientes sintomáticos apresentaram PTH1 significantemente menor e queda no PTH significativamente maior. Usando o valor de 12,1 ng/L como corte, conseguimos distinguir pacientes com e sem sintomas de hipocalcemia com sensibilidade de 93,7% e especificidade de 91,6%. Utilizando como corte a queda de 73,5% no valor do PTH, temos sensibilidade de 91,6% e especificidade de 87,5%. Conclusão: O PTH1 e a queda no PTH são bons preditores de hipocalcemia no pós-operatório de tireoidectomia total Arq Bras Endocrinol Metab. 2012;56(3):168-72

show abstract

Section: Resultsmentioning

confidence: 99%

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Vanderlei

Vieira

Hojaij

et al. 2012

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…Some authors (3)(4)(5)(6) consider early postoperative (24-hour) serum calcium levels and intraoperative identification of parathyroid glands to be important predictive factors. Others (7)(8)(9) have instead suggested combining intact parathyroid hormone (PTH) and serum calcium measurements, arguing that PTH and serum calcium monitoring after the first postoperative hour would allow reliable prediction of postoperative hypocalcemia. Some authors (10)(11)(12) recommend quick PTH assay as a means of predicting postoperative parathyroid function, although others (13) found no overall significant difference in the capacity of intraoperative PTH levels, versus early postoperative serum calcium levels (day 1), to predict long-term hypoparathyroidism.…”

Section: Introductionmentioning

confidence: 99%

Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study

Tartaglia

Giuliani

Sgueglia

et al. 2014

gchir

View full text Add to dashboard Cite

Hypocalcemia may be the only complication precluding a short postoperative hospital stay after total thyroidectomy (1, 2). Much has been written in the literature about the possibility of identifying (using different methods and predictors) which thyroidectomy patients will develop symptomatic hypocalcemia and which will not. Some authors (3-6) consider early postoperative (24-hour) serum calcium levels and intraoperative identification of parathyroid glands to be important predictive factors. Others (7-9) have instead suggested combining intact parathyroid hormone (PTH) and serum calcium measurements, arguing that PTH and serum calcium monitoring after the first postoperative hour would allow reliable prediction of postoperative hypocalcemia. Some authors (10-12) recommend quick PTH assay as a means of predicting postoperative parathyroid function, although others (13) found no overall significant difference in the capacity of intraoperative PTH levels, versus early postoperative serum calcium levels (day 1), to predict long-term hypoparathyroidism. In an attempt to identify reliable predictors of post-operative hypocalcemia, we measured ionized calcium levels before and after surgery and compared the data gathered with total serum calcium levels and symptoms of hypocalcemia (paresthesias and Chvostek's sign). The aim of the present study was to determine whether ionized calcium concentration is a better predictor of post-thyroidectomy hypocalcemia than total serum calcium.

show abstract

“…Early identification of patients at risk of hypocalcemia would allow prophylactic calcium supplementation therapy preventing development of symptomatic hypocalcemia. 6 In this study, 12 subjects had <12ng/ml parathyroid levels at 1,4,12 and 24 hours who were at high risk of developing hypocalcemia; started on oral calcium supplementation but later 2 (4%) out of 12 subjects developed symptoimatic hypocalcemia and 38 subjects had >/=12ng/ml parathyroid levels done at similar intervals as above were at low risk of developing hypocalcemia; although later 1 (2%) subjects developed symptomatic hypocalcemia as compared to study done by Chow et al, which used serum parathyroid levels as a criteria showed 2.8% of the patients developed hypocalcemia postoperatively. 7 Pattou et al, found that a postoperative PTH level of 12 pg/mL or less was a good predictor of hypocalcemia, but they did not state how long after surgery PTH values were obtained.…”

Section: Discussionmentioning

confidence: 99%

A prospective study on parathyroid hormone levels in detecting early hypocalcemia after total thyroidectomy

Kumar

Vinay

2017

Int Surg J

View full text Add to dashboard Cite

Background: Hypoparathyroidism and the resultant hypocalcaemia is a major cause of postoperative morbidity after total thyroidectomy with the incidence varying from 1% to 71%. This study aims to determine the incidence of parathyroid hormone deficiency as an earliest indicator for detecting hypocalcemia following total thyroidectomy.Methods: A prospective study was carried out among 50 subjects attending Department of Surgery, K. R. Hospital, Mysuru over a period of 12 months. Subjects of either sex undergoing total thyroidectomy had their serum parathyroid hormone levels tested at 1, 4, 12 and 24 hours after surgery were included in the study. Patients with poor compliance, calcium supplementation prior to surgery, coexisting parathyroid or renal pathology were excluded from the study. Descriptive statistics and Pearson correlation coefficients were used to analyse the results.Results: Among 50 study subjects, Hypocalcemia developed in 3 subjects (6%) 24 hours after thyroidectomy showing a sensitivity, specificity, negative and positive predictive value of 91%, 100%, 98% and 96% respectively.Conclusions: Parathyroid hormone levels in postoperative total thyroidectomy is an earliest indicator to detect symptomatic hypocalcemia subjects 24 hours after surgery, which prompts early administration of oral calcium replacement therapy in high risk subjects and potential safe early discharge post-operatively.

show abstract

Benefits Resulting from 1‐and 6‐Hour Parathyroid Hormone and Calcium Levels After Thyroidectomy

Cited by 59 publications

References 11 publications

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Parathyroid hormone: an early predictor of symptomatic hypocalcemia after total thyroidectomy

Is ionized calcium a reliable predictor of hypocalcemia after total thyroidectomy? A before and after study

A prospective study on parathyroid hormone levels in detecting early hypocalcemia after total thyroidectomy

Contact Info

Product

Resources

About