Use of Parathyroid Hormone Assay after Thyroidectomy: A Survey of US and European Surgeons

Stein, Daniel J.; Noordzij, J. Pieter; Kepchar, Jessica; McLeod, Ian K.; Brietzke, Scott E.; Calò, Pietro Giorgio

doi:10.4137/cmed.s13002

Cited by 8 publications

(6 citation statements)

References 25 publications

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“…Despite the conflicting evidence for the use of PTH, many have adopted it into practice. An anonymous survey of members from various American and European Endocrine Societies showed that 30% of American and 41% of European respondents reported routine use of PTH assay after thyroidectomy . However, PTH-based algorithms, guidelines, and practice measures need to be revisited because the evidence from existing literature is inconclusive with regard to PTH levels, interpretation thereof, and accuracy of PTH to predict hypocalcemia.…”

Section: Discussionmentioning

confidence: 99%

Association of Parathyroid Hormone Level With Postthyroidectomy Hypocalcemia

et al. 2018

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The existing literature regarding PTH levels to predict postthyroidectomy hypocalcemia is extremely heterogeneous. A single PTH threshold is not a reliable measure of hypocalcemia. Additional prospective studies controlled for timing of laboratory draws and a priori defined PTH thresholds need to be performed to ascertain the true prognostic significance of PTH in predicting postthyroidectomy hypocalcaemia.

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Section: Discussionmentioning

confidence: 99%

Association of Parathyroid Hormone Level With Postthyroidectomy Hypocalcemia

et al. 2018

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“…Such ideal and homogenous conditions cannot be universally implemented in real life but can be approximated in a questionnaire to investigate unanswered questions. [17][18][19][20] The International Survey on Interventional Strategy (ISIS) was launched to evaluate the extent to which current practice overlaps with practice guidelines, especially on the determination of significance of intermediate stenosis in stable CAD. Participants' views on best clinical practice and the impact on decision making of their overall and specific experiences in interventional cardiology were targeted by a single choice questionnaire using case presentations in the survey's virtual catheterization laboratory.…”

mentioning

confidence: 99%

Revascularization Decisions in Patients With Stable Angina and Intermediate Lesions

Tóth

Toth

Johnson

et al. 2014

Circ: Cardiovascular Interventions

146

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T he optimal treatment of patients with stable coronary artery disease (CAD) remains a matter of ongoing debate. Although revascularization provides an accepted symptomatic benefit, controversy lingers on its prognostic value when added to contemporary optimal medical care.1 Protagonists of medical therapy stress that revascularization, especially with percutaneous coronary intervention (PCI), does not reduce rates of death or myocardial infarction.2 Protagonists of mechanical therapy counter that most revascularization studies were based on anatomic guidance only, with visual estimation of stenosis severity from the coronary angiogram.3 Because ≤39% of angiographically obstructive coronary stenoses lack functional significance, no benefit should be expected from revascularizing nonischemic myocardium. 4 As a result, outcome results from existing trials are confounded by the neutral or negative effects arising from unnecessary interventions.

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“…To date, there is still no consensus about the usefulness of postoperative iPTH levels to predict permanent HPP [20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34]. We evaluated whether iPTH values on the first postoperative day may be a good predictor of this complication.…”

Section: Discussionmentioning

confidence: 99%

Correlation between iPTH levels on the first postoperative day after total thyroidectomy and permanent hypoparathyroidism: our experience

et al. 2019

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AbstractPermanent hypoparathyroidism is the most common long-term complication after thyroidectomy. We evaluated whether iPTH concentrations on the first postoperative day may be a good predictor of this complication.Patients undergoing thyroidectomy in our Unit between January 2017 and February 2018 who developed postsurgical hypoparathyroidism were analysed. According to iPTH values on the first postoperative day and on the basis of the detection threshold of the iPTH test used, patients were divided into 2 groups: Group A (iPTH < 6.3 pg/mL, undetectable), Group B (iPTH ≥ 6.3 pg/mL).Seventy-five patients were included in this study: 64 in Group A and 11 in Group B. Permanent hypoparathyroidism occurred in 14 (21.88%) patients in Group A, while none developed this complication in Group B. When iPTH was < 6.3 pg/mL, the sensitivity for the prediction of permanent hypoparathyroidism was 100%, the specificity was 18.03%, the positive predictive value was 21.88% and the negative predictive value was 100%.No patient with iPTH ≥ 6.3 pg/mL on the first postoperative day developed permanent hypoparathyroidism. On the other hand, iPTH concentrations < 6.3 pg/mL have not proved to be a strong predictor of this condition. However, this cut-off value can be useful to identify patients at risk of developing this complication.

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Use of Parathyroid Hormone Assay after Thyroidectomy: A Survey of US and European Surgeons

Cited by 8 publications

References 25 publications

Association of Parathyroid Hormone Level With Postthyroidectomy Hypocalcemia

Association of Parathyroid Hormone Level With Postthyroidectomy Hypocalcemia

Revascularization Decisions in Patients With Stable Angina and Intermediate Lesions

Correlation between iPTH levels on the first postoperative day after total thyroidectomy and permanent hypoparathyroidism: our experience

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