First Day Serum Calcium And Parathyroid Hormone Levels as Predictive Factors for Safe Discharge after Thyroidectomy

Abstract

Context. Permanent hypocalcemia is a rare but significant complication of thyroid surgeryObjective. The aim of this study was to identify predictive factors of hypocalcemia and hypoparathyroidism after thyroidectomy .Design. Study included 134 total patients submitted to thyroidectomy from two endocrine units (January 2015 -August 2016).Methods. We measured total serum calcium (sCa) and intact PTH (iPTH) on postoperative day one and 1 month after surgery.Results. 118 patients were women with F/M ratio of 7.3/1 and a mean age of 51.8 years. 64 patients were included in group A (iPTH <12 pg/mL) and 70 patients in group B (iPTH >12 pg/mL). sCa and hypocalcemia symptoms were correlated with iPTH, measured 24 hours after surgery. The cut-off value was for sCa 8.05 mg/dL with a sensitivity of 85.29% and a specificity of 88.0% and for iPTH 11.2 pg/mL, with a sensitivity of 82.3% and a specificity of 71.0%. SCa (< 8.05 mg/dL) was a predictive factor with a 99 (IC95%:12.86-761.58) and iPTH (<11.2 pg/mL) with a 10.77 higher risk (CI95%: 3.83-30.30) to be associated with symptoms.Conclusion. SCa and iPTH represent good predictive factors of early and safe hospital discharge and can predict the risk of prolonged and permanent hypoparathyroidism.

Pseudopseudohypoparathyroidism as a Cause of Fahr Syndrome: Hypoparathyroidism not the Only One

“…Iatrogenic hypoparathyroidism might be seen in the patients after thyroidectomy operations. After thyroid surgery hypocalcemia can be caused by various situations (18). In the follow-up period, neurological symptoms may develop due to this complication in these patients, like our first patient.…”

Complications, Symptoms, Presurgical Predictors in Patients With Chronic Hypoparathyroidism: A Systematic Review

“…Screening identified 1619 abstracts of which 521 proved duplicates, leaving 1098 abstracts for review, of which 118 proved potentially eligible. Of these, 17 articles including 18 studies proved eligible ( 95‐111 ) (Fig. S2).…”

“…The 18 studies (10 retrospective, (95,96,(100)(101)(102)104,105,107,110,111) and eight prospective, (96)(97)(98)(99)103,106,108,109) ) included 4325 patients, most of whom were women (n = 3457, 80%). Studies varied in their inclusion of malignant disease as an indication for surgery; autotransplantation of parathyroid glands during surgery; consideration of both PTH and calcium as predictors; their definition of chronic hypoparathyroidism; and the prevalence of chronic hypoparathyroidism.…”

“…In Part I, eligible studies identified 170 complications and symptoms derived from 93 studies in 18,973 patients with chronic hypoparathyroidism. Of these, nine complications and symptoms were reported in three or more studies and occurred more often in patients with hypoparathyroidism than in individuals (96,98,103,109) 12-24 hours postoperative 12 (67) (95,97,(99)(100)(101)(102)104,105,107,108,110,111) Threshold Absolute value, pg/mL (pmol/L) ≤10 (1.05) 12 (66) (95,96,98,(100)(101)(102)104,107,(109)(110)(111) 10-15 (1.05-1.58) 4 ( 22) (99,103,105,108) Change in value >50% 1 (6) (97) <50% 0 Combination Absolute <9.3 pg/mL (0.98 pmol/L) and change of >86% 1 (6) (106) Timing of determination of chronic hypoparathyroidism after surgery 3 months (95,99,102,(104)(105)(106)(107)109) Timing of determination of chronic hypoparathyroidism 6 months 6 (67) (95,99,…”

“…Part II: Predicting values of early parathyroid hormone and calcium levels with the development of chronic hypoparathyroidism in patients following total thyroidectomy Screening identified 1619 abstracts of which 521 proved duplicates, leaving 1098 abstracts for review, of which 118 proved potentially eligible. Of these, 17 articles including 18 studies proved eligible (95)(96)(97)(98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108)(109)(110)(111) (Fig. S2).…”