Use of the parathyroid hormone assay at H6 post thyroidectomy: an early predictor of hypocalcemia
Purpose Hypocalcemia linked to a diminished circulating intact parathormone (iPTH) is the most common complication after total thyroidectomy. The objective of this study was to evaluate iPTH as a predictor of post-thyroidectomy hypocalcemia. Methods Hundred-and-eight patients who underwent total thyroidectomy were included. Blood samples (iPTH, calcium and albumin) were performed at different times: preoperatively ($ H_{0} $), after removal of the gland ($ H_{drop} $), 6 h ($ H_{6} $) and one day ($ D_{1} $) after the surgery. Hypocalcemia was defined by total calcium corrected by serum albumin ≤ 2.10 mmol/l. The area under the ROC curve (AUC) was used to determine the best cut-off value and predictability of iPTH for hypocalcemia in terms of absolute value (ng/L), decrease in the slope (ng/L) and decline (%) between two times. Results The study included 101 patients. Among them, 39 had hypocalcemia (38.6%). At $ H_{6} $, 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 sloop and decline between preoperative and postoperative values were less relevant. Conclusion The iPTH 6 h after total thyroidectomy is predictive of hypocalcemia. It might be used to identify patients not at risk of hypocalcemia and earlier discharge could be considered..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Journal of endocrinological investigation - 45(2021), 1 vom: 03. Juli, Seite 1-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lacroix, C. [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
General surgery |
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| Anmerkungen: |
© Italian Society of Endocrinology (SIE) 2021 |
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| doi: |
10.1007/s40618-021-01601-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Purpose Hypocalcemia linked to a diminished circulating intact parathormone (iPTH) is the most common complication after total thyroidectomy. The objective of this study was to evaluate iPTH as a predictor of post-thyroidectomy hypocalcemia. Methods Hundred-and-eight patients who underwent total thyroidectomy were included. Blood samples (iPTH, calcium and albumin) were performed at different times: preoperatively ($ H_{0} $), after removal of the gland ($ H_{drop} $), 6 h ($ H_{6} $) and one day ($ D_{1} $) after the surgery. Hypocalcemia was defined by total calcium corrected by serum albumin ≤ 2.10 mmol/l. The area under the ROC curve (AUC) was used to determine the best cut-off value and predictability of iPTH for hypocalcemia in terms of absolute value (ng/L), decrease in the slope (ng/L) and decline (%) between two times. Results The study included 101 patients. Among them, 39 had hypocalcemia (38.6%). At $ H_{6} $, 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 sloop and decline between preoperative and postoperative values were less relevant. Conclusion The iPTH 6 h after total thyroidectomy is predictive of hypocalcemia. It might be used to identify patients not at risk of hypocalcemia and earlier discharge could be considered. | ||
| 650 | 4 | |a Parathyroid hormone |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Thyroidectomy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hypocalcemia |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Predictive value of tests |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a General surgery |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a ROC curve |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Potard, G. |4 aut | |
| 700 | 1 | |a Thuillier, P. |4 aut | |
| 700 | 1 | |a Le Pennec, R. |4 aut | |
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| 700 | 1 | |a Roudaut, N. |0 (orcid)0000-0001-6238-5389 |4 aut | |
| 700 | 1 | |a Marianowski, R. |0 (orcid)0000-0001-8545-9045 |4 aut | |
| 700 | 1 | |a Leclere, J.-C. |0 (orcid)0000-0002-1303-9575 |4 aut | |
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