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KMID : 0371320060710040250
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Journal of the Korean Surgical Society
2006 Volume.71 No. 4 p.250 ~ p.255
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Evaluation of Perioperative Serum Parathyroid Hormone Levels in Predicting Post-thyroidectomy Hypocalcemia
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장호영/Jang HY
김지아/길원호/최영진/우상욱/김정한/남석진/양정현/Kim JA/Kil WH/Choi YJ/Woo SU/Kim JH/Nam SJ/Yang JH
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Abstract
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Purpose: Postoperative hypocalcemia is one of the most common complications in patients who undergo a bilateral thyroid resection and can prolong hospital stay. However, there is no reliable predictor of clinical hypocalcemia after a thyroidectomy. The aim of this study was to identify the clinical predictors of hypocalcemia after a thyroidectomy and to determine if the perioperative measurements of iPTH would be helpful in identifying patients at risk of post-thyroidectomy hypocalcemia.
Methods: 213 consecutive patients undergoing thyroidectomy between Nov 2004 and Feb 2005 were examined. The iPTH, serum calcium and ionized calcium levels were measured at 6 hours, 1 day and 2 weeks after surgery, respectively. All the patients were divided into the lower PTH group (＜10 pg/ml) and normal PTH group according to the level of iPTH measured at 6 hours after surgery.
Results: The lower PTH group comprised 33% of all patients: 39% after the total thyroidectomy and 11% after a less than total thyroidectomy. The incidence of IV calcium replacement was 36% in the lower PTH group compared with 13% in the normal PTH group. Hypocalcemia and a lowered PTH level occurred more frequently in patients who underwent surgery for a malignant tumor than for a benign tumor.
Conclusion: There was a correlation between the level of ionized calcium and the incidence of calcium replacement and with the 6 hr-later iPTH level. Therefore, a iPTH level ≤10 pg/ml at 6 hour after the thyroidectomy might predict the development of clinically significant hypocalcemia. (J Korean Surg Soc 2006;71:250-255)
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