April - June 2020, Volume 16, Issue 2

Soylu S, Teksoz S

Earlier Prediction of Hypocalcemia by Postoperative Second Hour Parathyroid Hormone Level after Total Thyroidectomy

Acta Endo (Buc) 2020, 16 (2): 250-255
doi: 10.4183/aeb.2020.250

Context. Thyroidectomy is becoming an ambulatory surgical procedure. By predicting hypocalcemia,duration of hospital stay might decline. We tried to determine whether measuring parathormone two hours after total thyroidectomy predicts hypocalcemia. Objective. We aimed to design a protocol for early prediction of hypocalcemia by defining PTH measurement time and cut-off value of our center. Design. One hundred and six patients undergoing total thyroidectomy between November 2017 and October 2018 were prospectively studied. Methods. Pregnant women, patients with renal failure, parathyroid disease, previous neck operation and thyroid malignancy requiring neck dissection were excluded from the study. Parathormone (PTH) and calcium measurement was done preoperatively and in the postoperative second hour. Results. Group 1 consisted of 75 normocalcemic patients while group 2 had 31 hypocalcemic patients. Mean age was 45±13.1 (age range: 18-76). Female/male ratio was 82/24. While with a 8.36 pg/mL postoperative second hour PTH, hypocalcemia can be predicted with a 51.5% sensitivity and 90.7% specificity while with a PTH decline of 40.8% hypocalcemia can be diagnosed with a 83.9% sensitivity and 52% specificity. Conclusion. Postoperative second hour PTH and PTH percentage decline can predict postoperative hypocalcemia in total thyroidectomies. Preoperative Dualenergy X-ray absorptiometry (DXA) was not found useful in hypocalcemia prediction.

Keywords: parathyroid hormone level, hypocalcemia, thyroidectomy.

Correspondence: Selen Soylu MD, Istanbul University-Cerrahpasa - Department of General Surgery, Ataköy 4. Kisim 0.187 block d 18 Istanbul, 34440, Turkey, E-mail: selen_soylu@yahoo.com