April - June 2019, Volume 15, Issue 2

Sala DT, Muresan M, Voidazan S, Cvasciuc T, Darie R, Danielopol V, Muresan S, Pascanu I

First Day Serum Calcium And Parathyroid Hormone Levels as Predictive Factors for Safe Discharge after Thyroidectomy

Acta Endo (Buc) 2019, 15 (2): 225-230
doi: 10.4183/aeb.2019.225

Context. Permanent hypocalcemia is a rare but significant complication of thyroid surgery Objective. The aim of this study was to identify predictive factors of hypocalcemia and hypoparathyroidism after thyroidectomy . Design. Study included 134 total patients submitted to thyroidectomy from two endocrine units (January 2015 – August 2016). Methods. We measured total serum calcium (sCa) and intact PTH (iPTH) on postoperative day one and 1 month after surgery. Results. 118 patients were women with F/M ratio of 7.3/1 and a mean age of 51.8 years. 64 patients were included in group A (iPTH <12 pg/mL) and 70 patients in group B (iPTH >12 pg/mL). sCa and hypocalcemia symptoms were correlated with iPTH, measured 24 hours after surgery. The cut-off value was for sCa 8.05 mg/dL with a sensitivity of 85.29% and a specificity of 88.0% and for iPTH 11.2 pg/mL, with a sensitivity of 82.3% and a specificity of 71.0%. SCa (< 8.05 mg/dL) was a predictive factor with a 99 (IC95%:12.86- 761.58) and iPTH (<11.2 pg/mL) with a 10.77 higher risk (CI95%: 3.83-30.30) to be associated with symptoms. Conclusion. SCa and iPTH represent good predictive factors of early and safe hospital discharge and can predict the risk of prolonged and permanent hypoparathyroidism.

Keywords: thyroidectomy, postoperative hypoparathyroidism, postoperative hypocalcemia.

Correspondence: Mircea Muresan, University of Medicine, Pharmacy, Science and Technology of Targu Mures, Gh.Marinescu st, no.38, Targu Mures, Mures, 540134, Romania, E-mail: dr_muremir@yahoo.com