Prediction of post-idroidectomy hypocalcemia through rapid PTH determination.

Cirugía española
Gonzalo Gutiérrez FernándezDaniel Casanova Rituerto

Abstract

Hypocalcemia is the most frequent complication after thyroidectomy. The aim of this work is to identify biochemical risk factors of hypocalcemia using quick perioperative (pre and post-thyroidectomy) intact parathyroid hormone (PTHi) and postoperative calcemias. In a consecutive series of 310 total thyroidectomies, samples of quick PTHi at the anaesthetic induction and 10 minutes after surgery, together with serum calcemias every 12 hours were obtained. The sensitivity, specificity, positive and negative predictive value are analyzed and related to hypocalcemia. A control group of hemithyroidectomies is also analyzed to compare the effects of surgery on PTH secretion. Of the 310 patients, 202 (65.1%) remained normocalcemic and asymptomatic (group A), 108 (34.9%) presented hypocalcemia (Group B), requiring oral calcium (79 symptomatic). After analysis of several cut-off points, combining a PTHr drop gradient of 60% or calcemia inferior to 7.4 mg/dl at 24 hours, a sensitivity of 100% is achieved without leaving false negatives. Compared to the control group, there is a significant difference with respect to the post-operative calcemias and PTHr, p < 0.001. Total thyroidectomy affects parathyroid function with evident decrease in ...Continue Reading

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Citations

May 10, 2021·Cirugía española·José Luis Muñoz de NovaÁlvaro Valdés de Anca
Aug 4, 2021·Cirugia Española·José Luis Muñoz de NovaÁlvaro Valdés de Anca

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