Parathyroid hormone and serum calcium levels measurements as predictors of postoperative hypocalcemia in total thyroidectomy

Algarni, Mohammed; Alzahrani, Rajab; Dionigi, Gianlorenzo; Hadi, Al-Hakami; AlSubayea, Haia

doi:10.21037/gs.2017.06.12

Cited by 14 publications

(6 citation statements)

References 20 publications

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“…Monitoring the level of serum total calcium (Ca) or ionized calcium (iCa++), circulating slopes in the change of Ca or iCa ++, measuring intraoperative or standard intact parathyroid hormone level, and making a new algorithm by combining more than two of these values have all been reported as useful predictors 5. However, these predictors also facilitate the thyroid surgeon, which patient can be discharge early and hospital budget can be saved 9. Our objective was to determine the frequency of postoperative hypocalcaemia undergoing Total thyroidectomy.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Hypocalcaemia following Total Thyroidectomy

Baloch

Taj²,

Anwer

et al. 2019

Pak J Med Sci

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Background & Objective: Patients who undergo Total thyroidectomy are at higher risk for postoperative hypocalcaemia, which can lead to significant short and long term morbidity. The aim of this study was to determine the frequency of postoperative hypocalcaemia undergoing Total thyroidectomy. Methods: A total of 854 patients who underwent Total thyroidectomy and completion thyroidectomy between January 2003 to December 2016 at Endocrine Surgical unit, Jinnah Postgraduate Medical Centre, Karachi, were included in this retrospective study. Data were obtained for demographics, preoperative diagnosis, postoperative calcium levels, extent of surgery and final surgical pathology. Results: A total of 854 patients underwent Total thyroidectomy. Of these 87.58% (n=748) were malignant and 12.41% (n=106) were benign. Among the malignant and benign patients, 47.3% (n=404) underwent Total thyroidectomy and 52.69% (n=450) underwent completion thyroidectomy. Overall incidence of transient hypocalcaemia was 7% (n=60) and that of permanent hypocalcaemia was 0.11% (n= 1). Conclusion: Hypocalcaemia is one of major concern following total- thyroidectomy. Meticulous surgical techniques, identification and preservation of vascularity of parathyroid glands are essential in preventing postoperative hypocalcaemia following total thyroidectomy. How to cite this:Baloch N, Taj S, Anwer M, Naseem M. Frequency of Hypocalcaemia following Total Thyroidectomy. Pak J Med Sci. 2019;35(1):262-265. doi: https://doi.org/10.12669/pjms.35.1.93 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

Frequency of Hypocalcaemia following Total Thyroidectomy

Baloch

Taj²,

Anwer

et al. 2019

Pak J Med Sci

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“…Aside from the fact that young patients are at a higher risk of developing post thyroidectomy hypocalcaemia caused by their age [17] and others eminent risk factors. Multiple studies in this review identified dissection of lymph node [18,19], the Grave's disease presence [20] or malignancy [21] as post-operative hypocalcaemia independent predictors, and total thyroidectomy [22].…”

Section: Discussionmentioning

confidence: 99%

Frequency of Hypocalcaemia following total Thyroidectomy

Mumtaz¹,

Rehman²,

Nauman³

et al. 2021

PJMHS

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Background: The most common post-thyroidectomy complication is hypocalcaemia. It could be permanent or transitory. Permanent hypocalcaemia has a prevalence of 0-13% and transient hypocalcaemia has a prevalence of 1-6%. Aim: The study objective was to ascertain the prevalence of postoperative hypocalcaemia in patients following total thyroidectomy. Materials and Methods: This cross-sectional study was carried out on 84 thyroid patients who underwent total thyroidectomy in the surgical department of HBS General Hospital, Islamabad for period of nine months during from September 2020 to May 2021. Patients within the age range of 15-69 years and had indicated thyroidectomy caused by carcinoma thyroid, multinodular goiter, and recurrent goiter were enrolled. Inform consent was obtained from each participant. Ethical approval was taken from the institutional ethical committee. Thyroid profile and serum calcium were done for a routine investigation. Serum calcium levels were measured 24 hours, 48 hours, and 7 days after total thyroidectomy. Signs and symptoms in hypocalcaemia patients were recorded on a proforma. Patients with hypocalcaemia were followed for six months. SPSS version 20 was used for data analysis. Results: The mean age of the patients was 46.7 ± 4.6 years with an age range of 16 to 69 years. Of the total 84 patients, 38 (45.2%) underwent total thyroidectomy and 46 (54.8%) underwent a complete thyroidectomy. The prevalence of male and female patients was 22 (26.2%) and 62 (73.8%) respectively. Malignant and benign were present in 71 (84.5%) and 13 (15.5%) respectively. Of the total 84 patients, 68 (81%) developed hypocalcaemia. Out of 68 hypocalcaemia patients, 29 (42.6%) and 39 (57.4%) were from the benign and malignant groups respectively. Conclusion: Postoperatively hypocalcaemia was prevalent following thyroidectomy. Malignant patients (84.5%) were more prevalent compared to benign patients (15.5%) after total thyroidectomy. Careful surgical procedures, parathyroid gland vascularity preservation, and identification are critical in preventing hypocalcaemia following total thyroidectomy. Keywords: Hypocalcaemia; Total thyroidectomy; Complete Thyroidectomy

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“…Female patients were at higher risk of developing postoperative hypoparathyroidism (53/142, 37.3%) compared to male patients (6/47, 12.7%, p < 0.001). Female sex and age were found to be significant risk factors for postoperative hypocalcemia with conflicting results: in their retrospective study, Karadeniz and Akcay [ 27 ], found that young age (<28.5 years old) and female sex were risk factors for post-operative hypocalcemia; in contrast, Algarni’s retrospective analysis [ 28 ] found no significant correlation with female sex, probably because of the small sample size of the study (40 patients).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Low Levels of Parathyroid Hormone after Surgery for Thyroid Cancer: A Single Center Study

Privitera

Gioco

Fazio

et al. 2021

JCM

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Background: Thyroidectomy is the definitive treatment for most patients with thyroid cancer. Hypoparathyroidism is the most frequent complication of thyroidectomy, and its pathogenesis is multifactorial. The aim of this study is to evaluate the patient- and surgical-related risk factors for hypoparathyroidism after surgery for thyroid cancer. Methods: In this retrospective study, patients referred to surgery for thyroid cancer from 2016 to 2019 were enrolled. Preoperative serum calcium and parathyroid hormone (PTH) and postoperative 24 h PTH and calcium levels were evaluated. Demographic data, type of surgery, incidence of hypoparathyroidism and hypocalcemia were recorded for all the patients. Patients were divided into two groups based on post-operative PTH levels (≤12 and >12 pg/mL). Results: A total of 189 patients were enrolled in this study. There were 146 women (87.3%) and 43 men (22.7%), with a mean age of 51.3 years. A total of 79 patients (41.7%) underwent a neck dissection. A total of 59 patients (31.1%) had a postoperative PTH level < 12 pg/mL. Female sex, neck dissection, the yield of lymph node dissection and incidental parathyroidectomy were significantly associated with postoperative hypoparathyroidism. Incidental parathyroidectomy was reported in 44 (23.2%) patients and was correlated with younger age (<40 years) and neck dissection. There was no difference in the rate of post-operative hypocalcemia between patients with incidental parathyroidectomy and those without. Conclusions: Young patients undergoing neck dissection and with incidental parathyroidectomy have the highest risk of postoperative hypoparathyroidism after surgery for thyroid cancer. However, a large proportion of patients without incidental parathyroidectomy may have temporary hypocalcemia, suggesting that impaired blood supply of parathyroid glands during their identification and dissection may play a relevant role.

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Parathyroid hormone and serum calcium levels measurements as predictors of postoperative hypocalcemia in total thyroidectomy

Cited by 14 publications

References 20 publications

Frequency of Hypocalcaemia following Total Thyroidectomy

Frequency of Hypocalcaemia following Total Thyroidectomy

Frequency of Hypocalcaemia following total Thyroidectomy

Risk Factors for Low Levels of Parathyroid Hormone after Surgery for Thyroid Cancer: A Single Center Study

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