Home Bratislava Medical Journal 2014 Bratislava Medical Journal Vol.115, No.3, p.175-178, 2014

Journal info


 


Published Monthly, in English
Founded: 1919
ISSN 0006-9248
(E)ISSN 1336-0345

Impact factor 1.564

 

Aims and Scope
Editorial Info
Submission Guidelines

Select Journal







Webshop Cart

Your Cart is currently empty.

Info: Your browser does not accept cookies. To put products into your cart and purchase them you need to enable cookies.

Bratislava Medical Journal Vol.115, No.3, p.175-178, 2014

Title: Hypocalcemia – the most common complication after total thyroidectomy
Author: P. Cmilansky, L. Mrozova

Abstract:

Objectiva: Postoperative intact parathyroid hormone (iPTH) levels and some other factors as a predictor of hypocalcemia are analyzed in 115 patients after TTE.
Background: Postoperative hypocalcemia is the most common complication observed after total thyroidectomy (TTE). It is not easy to predict in which patients this complication will occur. We adopted and implemented a novel method to predict this complication – monitoring of postoperative intact parathyroid hormone (iPTH) levels.
Methods and results: Prospective study involves 115 patients. From January till December 2010 we performed 111 TTE and 4 completion thyreoidectomies (hemithyreoidectomy (HTE)  after previous HTE). Gender and age of patients, final histopatology diagnosis, number of parathyroid glands visible during operation, duration of operation and surgeon were factors that did not influence development of postoperative hypocalcemia. A hospital stay was prolonged in patients with hypocalcemia. iPTH level morning after surgery less than 15 pg/ml was a statistically significant predictor of postoperative hypocalcemia.

Sensitivity, specificity, positive and negative predictive value of iPTH<15 pg/ml for predicting postoperative hypocalcemia were 71 %, 99 %, 97 % and 86 %, respectively.

Sensitivity of iPTH<15 pg/ml in predicting symptomatic postoperative hypocalcemia was 100 %.


Conclusion: Measuring iPTH levels morning after TTE allows prediction of subsequent hypocalcemia with a high sensitivity, specificity, PPV and NPV. Normal iPTH levels ruled out development of hypocalcemia symptoms. Patients with normal iPTH can be safely discharged and the overtreatment of postthyroidectomy patients with calcium and/or vitamin D supplements can be also avoided (Tab. 2, Fig. 3, Ref. 29).



Keywords: thyroid surgery, hypocalcemia, hypoparathyroidism, parathormone.
Year: 2014, Volume: 115, Issue: 3 Page From: 175, Page To: 178
doi:10.4149/BLL_2014_037


download file



© AEPress s.r.o
Copyright notice: For any permission to reproduce, archive or otherwise use the documents in the ELiS, please contact AEP.