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

Karatzanis, Alexander D.; Ierodiakonou, Despo; Fountakis, Emmanuel S.; Velegrakis, Stylianos; Doulaptsi, Maria; Prokopakis, Emmanuel P.; Daraki, Vasiliki; Velegrakis, George A.

doi:10.1002/hed.25081

Cited by 19 publications

(39 citation statements)

References 31 publications

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“…Low post-operative PTH was found to have a statistically significant association with transient biochemical hypocalcaemia in 24 studies, 10–33 compared with 3 studies where there was not a statistically significant result 34–36 . Low intra-operative PTH levels and a larger differential PTH from the pre-operative to post-operative stage were also seen to have statistically significant associations in 2 studies 37,38 and 13 studies 10,12,14,15,22,23,27,29,31,36,39–41 , respectively. Pre-operative PTH showed a non-significant association with transient biochemical hypocalcaemia in the majority of studies.…”

Section: Resultsmentioning

confidence: 81%

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Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

2020

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AbstractObjectiveHypocalcaemia is the most common complication after total or completion thyroidectomy. This study assesses recent evidence on predictive factors for post-thyroidectomy hypocalcaemia in order to identify the patients affected and aid prevention.MethodTwo authors independently assessed articles and extracted data to provide a narrative synthesis. This study was an updated systematic search and narrative review regarding predictors of post-thyroidectomy hypocalcaemia using the Ovid Medline, Embase, Cochrane and Cinahl databases. Results were limited to papers published from January 2012 to August 2019.ResultsSixty-three observational studies with a total of 210 401 patients met the inclusion criteria. The median incidence was 27.5 per cent for transient biochemical hypocalcaemia, 12.5 per cent for symptomatic hypocalcaemia and 2.2 per cent for permanent hypocalcaemia. The most frequent statistically significant predictor of hypocalcaemia was peri-operative parathyroid hormone level. Symptomatic hypocalcaemia and permanent hypocalcaemia were seen more frequently in patients undergoing concomitant neck dissection.ConclusionMany factors have been studied for their link to post-thyroidectomy hypocalcaemia, and this study assesses the recent evidence presented in each case.

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Section: Resultsmentioning

confidence: 81%

“…Pre-operative PTH showed a non-significant association with transient biochemical hypocalcaemia in the majority of studies. 10,12,15,19,22,23,29,31,34–37,39,40,42,43…”

Section: Resultsmentioning

confidence: 99%

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

2020

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“…[11–16] Moreover, intravenous calcium administration to patients with refractory hypocalcaemia is a major reason for prolonged hospitalization after thyroid surgery. [17]…”

Section: Introductionmentioning

confidence: 99%

Role of oral calcium supplementation alone or with vitamin D in preventing post-thyroidectomy hypocalcaemia

Xing¹,

Wang

et al. 2019

Medicine

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“…El hipoparatiroidismo posoperatorio representa la complicación más frecuente luego de una tiroidectomía total 6,7 . Se clasifica como transitorio cuando su duración es menor de 6 meses y como definitivo cuando persiste por más tiempo.…”

Section: Introductionunclassified

“…El hipoparatiroidismo transitorio se presenta en el 1,7-68% de los pacientes, mientras que su forma definitiva afecta al 1-12% en las distintas series publicadas 4,[8][9][10][11] . Esta complicación se manifiesta en las primeras 24-96 horas posteriores a la cirugía, motivo por el cual en muchas instituciones los pacientes permanecen internados durante este tiempo 4,7,8 . Una vez instalado el hipoparatiroidismo, requiere tratamiento con reposición de calcio y vitamina D, y un monitoreo estricto con el fin de evitar, detectar o tratar las manifestaciones graves de la hipocalcemia (arritmias, tetania, etc.)…”

Section: Introductionunclassified

Utilización de la parathormona como predictor de hipoparatiroidismo postiroidectomía total

Torre¹,

Gómez²,

Abuawad³

et al. 2020

CIRU

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Antecedentes: El hipoparatiroidismo posoperatorio constituye la complicación más frecuente de la tiroidectomía total. Se asocia, entre otras cosas, a internación prolongada y múltiples pruebas de laboratorio, y con ello a un incremento en los costos de salud. La identificación de pacientes con mayor riesgo de padecer esta complicación permite realizar un tratamiento precoz, disminuyendo el costo económico y evitando complicaciones asociadas a un retraso en la externación. Se han descrito diversos predictores para identificar tempranamente a los pacientes en riesgo; en los últimos años, ha tomado particular relevancia el uso de la parathormona (PTH). Objetivo: El objetivo del presente trabajo es revisar la literatura existente sobre la utilidad de la PTH como predictor de hipocalcemia postiroidectomía. Método: Se realizó una búsqueda en PubMed revisando la evidencia existente sobre eficacia de la PTH como predictor de hipocalcemia posoperatoria, su repercusión económica, el tiempo óptimo para la toma de muestra y el modo de implementación. Conclusión: El uso de la PTH permite predecir con adecuada sensibilidad, especificidad, valor predictivo negativo y valor predictivo positivo los pacientes en riesgo de padecer hipocalcemia posoperatoria. Sin embargo, los valores de corte, los tiempos de toma de muestra y la cantidad de estas varían entre los autores, por lo que persisten algunos interrogantes acerca de la estandarización de su uso.

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

Abstract: Serum PTH levels on the first postoperative day may be used as a reliable predictive marker for calcium supplementation need and even prolonged hospitalization in cases undergoing total thyroidectomy.

Cited by 19 publications

References 31 publications

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

Predictors of post-thyroidectomy hypocalcaemia: a systematic and narrative review

Role of oral calcium supplementation alone or with vitamin D in preventing post-thyroidectomy hypocalcaemia

Utilización de la parathormona como predictor de hipoparatiroidismo postiroidectomía total

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