Interest of the Parathyroid Hormone Assay: An Early Predictor of Post‐thyroidectomy Hypocalcemia. (2nd September 2014)

• Record Type: Journal Article
• Authors: La Croix, Candice; Potard, Gael; Valette, Gerald; Marianowski, Remi
• Is Part Of: Otolaryngology--head and neck surgery. Volume 151(2014)Supplement 1
• Page Start: P171
• Page End: P171
• Publication Date: 2014-09-02
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814541629a105
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: Hypocalcemia linked to a diminished circulating intact parathormone (iPTH) is the most common complication after total thyroidectomy. The outcome of our single‐center prospective study is to determine the interest of iPTH as a predictor of post‐thyroidectomy hypocalcemia. Methods: One hundred eight patients who underwent total thyroidectomy were included. Blood samples (iPTH, calcium, and albumin) were performed at different times: preoperatively (H0), after removal of the gland (Hdrop), 6 hours (H6) after surgery, and one day (D1) after surgery. A measurement of calcium and albumin was performed on the second postoperative day (D2). The area under the receiver‐operating characteristic (ROC) curve (AUC) was used to determine the best cutoff value and predictability of iPTH for hypocalcemia in terms of absolute value (ng/L), decrease in the slope (ng/L), and decline (%) between 2 times. Results: Seven patients were excluded. Of the remaining 101 patients, 39 had hypocalcemia (38.6%). At H6, an iPTH absolute value less than 14.35 ng/L (Se = 0.706; Sp = 0.917) and a decline from the preoperative time of more than 59.5% (Se = 0.850; Sp = 0.820) were predictive of hypocalcemia. Other absolute values, decrease in the slope, and decline between preoperative and postoperative values are less efficient. Conclusions: The iPTH 6 hours after total thyroidectomy is predictive of hypocalcemia. It could be used to identify patients not at risk of hypocalcemia, and earlier discharge could be considered.