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KMID : 1202020100030020160
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Journal of Korean Thyroid Association
2010 Volume.3 No. 2 p.160 ~ p.165
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Early Predictor of Hypocalcaemia after Total Thyroidectomy
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Kim Ho-Yeop
Kim Jin-Pyeong
Park Jung-Je
Ahn Seong-Yong
Woo Seung-Hoon
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Abstract
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Background and Objectives :Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study is to determine whether measurement of intact parathyroid hormone (i-PTH) concentrations in the early postoperative period accurately predicts patients at risk of developing hypocalcaemia and safely discharged on the first postoperative day.
Materials and Methods : A prospective study of patients undergoing total thyroidectomy was carried out. Thirty eight patients were recruited into the study in the period May 2009 to March 2010. I-PTH concentrations, calcium, ionized calcium, P, Mg, were measured preoperatively and at 0 and 6 h, 12 h, 24 h, 72 h, 120 h postoperatively.
Results: Papillary thyroid carcinoma was the most common indication for surgery (96%). In the correlation of all the results and the presence of symptom using the logistic regression test. In the statistically result, i-PTH is linearly relative to the change of the test time. In the P, Mg, albumin, Ca, and ionized Ca, there are not. We compared with the odds ratio of i-PTH. I-PTH of post OP 6 hours is most relative to symptomatic prevalence and timely significant. After ROC analysis using the significant hormonal level of the post OP 6 hours, they are stratified by four groups ≤4.2, ≤7.1, ≤10.6, and ≤13.6 mg/dl, and compared one another.
Conclusion: An i-PTH measurement at 6 hours postoperatively allows for accurate prediction of patients at risk of hypocalcaemia. In the future patients with a normal postoperative i-PTH level can be safely discharged on the first postoperative day.
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KEYWORD
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Thyroidectomy, Hypocalcemia, Parathyroid hormone
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