Identification of Patients at High Risk for Postsurgical Hypoparathyroidism

In Vivo. 2020 Sep-Oct;34(5):2973-2980. doi: 10.21873/invivo.12128.

Abstract

Background/aim: Postsurgical hypoparathyroidism (PostHypo) is a common complication after total thyroidectomy. We studied the risk factors associated with PostHypo.

Patients and methods: The study included 109 women, (mean age: 50.7±10.75 years), who underwent total thyroidectomy for thyroid diseases.

Results: Based on the development of biochemical hypocalcemia on the first postoperative day following total thyroidectomy, (cCa<8.4 mg/dl), 37 women developed PostHypo and 72 did not. Younger age, a lower preoperative corrected calcium and the presence of parathyroid glands in the specimens were related to the development of PostHypo. Of all patients, 51.4% had a vitamin D deficiency. A parathyroid hormone (PTH) value ≤9.4 pg/ml was 84.9% sensitive and 71.4% specific to predict PostHypo on the 1st postoperative day. A 50% reduction of the PTH value on the 1st postoperative day from the preoperative level could identify patients who develop PostHypo with 76% sensitivity and 75% specificity.

Conclusion: PTH postoperative measurement and its alteration from the preoperative level can be used to identify patients who are at increased risk to develop PostHypo.

Keywords: Total thyroidectomy; acute postsurgical hypoparathyroidism; parathormone; postsurgical hypocalcemia.

MeSH terms

  • Adult
  • Calcium
  • Female
  • Humans
  • Hypocalcemia* / diagnosis
  • Hypocalcemia* / etiology
  • Hypoparathyroidism* / diagnosis
  • Hypoparathyroidism* / epidemiology
  • Hypoparathyroidism* / etiology
  • Middle Aged
  • Parathyroid Hormone
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Thyroidectomy / adverse effects

Substances

  • Parathyroid Hormone
  • Calcium