Postoperative calcium levels as a diagnostic measure for hypoparathyroidism after total thyroidectomy

Abstract

Objective: The aim of the present study was to identify a fast, efficient and low-cost method to diagnose hypoparathyroidism after total thyroidectomy. Materials and methods: One hundred and forty medical records, which contained patients' clinical and laboratory data, were retrospectively analyzed. Patient parathyroid hormone values, which were obtained immediately following operation, were compared with their ionized calcium levels the morning after surgery. This comparison was used to examine the correlation between the two variables in predicting hypoparathyroidism because measuring calcium levels is low-cost and more available in the hospitals compared to measuring parathormone (PTH) levels. Results: There was a positive and statistically significant correlation between PTH and ionized calcium values (Pearson correlation coefficient, r = 0.456; p < 0.0001). The values of first postoperative day ionized calcium levels (stratified by the 1.10 mmol/l cut-off value) were tested as a diagnostic measure for hypoparathyroidism, and a PTH < 15 pg/mL obtained immediately following operation served as a reference. This analysis showed that ionized calcium levels measured on the first postoperative day had a sensitivity of 45.6% (95% CI 30.9-61.0%), a specificity of 88.9% (95% CI 80.5-94.5%) and an accuracy of 76.7% (95% CI 68.7-83.5%) as a diagnostic measure for hypoparathyroidism. Conclusion: In conclusion, we demonstrated that patients who had high ionized calcium levels on the first postoperative day also had high PTH levels immediately following operation and, therefore, they had lower rates of hypoparathyroidism. Arch Endocrinol Metab. 2015;59(5):428-33

Early prediction of hypocalcaemia following total thyroidectomy by serial parathyroid hormone and ionized calcium assay

“…The present study showed highest incidence (30%) in > 50 years of age which is similar to the study conducted by Rosa KM et al 7 This might be due to difference in presentation of benign goitre, papillary and follicular carcinoma.…”

“…This was comparable to previous study. 7 Permanent hypoparathyroidism was a less frequent complication, with the incidence of 1.5 to 1.8%. 4,5 Permanent hypocalcaemia was absent in this study during the follow up period of one year.…”

Incidence and predictors of thyroid gland invasion by laryngeal carcinoma: a 7-year experience review

“…Another nonexistent important clinical factor was the postoperative calcium level whenever TT was performed. Patients may develop parathyroid glands stunning after TT even with surgery for benign pathology and hence they require calcium taper regimen over 3 weeks [26]. The unavailability of this information made it impossible for the research team to identify the true incidence of postoperative hypocalcemia after TT either temporary or permanent.…”

Timing of hypocalcemia after total or near total thyroidectomy: a prospective observational study

“…Measurement of serum calcium in the morning after the surgery is considered a fast and low-cost method to assess parathyroid function in the early post-operative period. 2 The aim of this study was to determine timing of hypocalcemia postoperatively and determine the safest day to discharge post-total/near-total thyroidectomy patients based on serum calcium level.…”