The role of early postoperative parathyroid hormone level after total thyroidectomy in prediction of hypocalcemia

Abdullah, Abdullah Saeed

doi:10.1016/j.amsu.2021.102252

Cited by 4 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In some studies to predict hypocalcemia after bilateral total thyroidectomy, some authors have found success with a single parathormone measurement [11]. As in our study, studies examining the difference between preoperative and postoperative parathormone levels also report successful results [13,14].…”

Section: Discussionsupporting

confidence: 73%

“…The median length of hospital stay was 4 (3-8.75) days. The mean preoperative calcium level was 11.04±0.86 (11) mg/dL, and after parathyroidectomy, the mean postoperative calcium level was 9.42±0.83 (9.5) mg/dL. The adjusted postoperative calcium mean was 9.34±0.78 (9.31) mg/dL.…”

Section: Resultsmentioning

confidence: 95%

“…In a study conducted by Abdullah et al on patients after total thyroidectomy, they predicted that the level of parathormone in the early postoperative period alone might be a marker for postoperative hypocalcemia [11]. Similarly, AlQahtani et al suggested that the postoperative first-hour parathormone level after bilateral total thyroidectomy alone can predict postoperative hypocalcemia [12].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Delta parathormone value as an indicator of postoperative hypocalcemia in patients with parathyroid adenoma

TOPÇU

Tutan²,

Kartal³

et al. 2023

J CLIN MED KAZ

View full text Add to dashboard Cite

Aim: In primary hyperparathyroidism patients, avoiding hypoparathyroidism and hypocalcemia after surgery is essential. We aimed to evaluate if the delta parathormone percent value (ΔPTH%) can identify patients with an increased risk of developing hypocalcemia after parathyroid surgery for primary hyperparathyroidism. Material and methods: Eighty patients with parathyroid adenomas who underwent single parathyroidectomy were analyzed, and demographical data, preoperative, and postoperative laboratory data were collected were included in the study. Postoperative hypocalcemia was defined as a corrected calcium value below 8.5 mg/dL calculated from the blood values taken on the first postoperative day. The ΔPTH value was calculated by finding the difference between the preoperative PTH value and the postoperative PTH value, and the percentage of ΔPTH was calculated by dividing the ΔPTH value by the preoperative PTH (ΔPTH = Preoperative PTH – Postoperative PTH, and ΔPTH% = ΔPTH / Preoperative PTH). Results: Postoperative hypocalcemia developed in 7.5% of the patients. Hypocalcemic patients had higher ΔPTH and ΔPTH% values. The selection of 130.95 ng/L as ΔPTH level cutoff level divided patients with and without postoperative hypocalcemia with 83.3% sensitivity and 62.2% specificity. As for ΔPTH%, a cut-off value of 71.4% had 100.0% sensitivity, 56.8% specificity, and a 16-fold increase in odds of postoperative hypocalcemia. Conclusion: ΔPTH and ΔPTH% values are helpful predictors of postoperative hypocalcemia after parathyroidectomy and can be used as a guiding tool.

show abstract

Section: Discussionsupporting

confidence: 73%

Section: Resultsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Delta parathormone value as an indicator of postoperative hypocalcemia in patients with parathyroid adenoma

TOPÇU

Tutan²,

Kartal³

et al. 2023

J CLIN MED KAZ

View full text Add to dashboard Cite

show abstract

“…The normal range of serum calcium level is 2.13-2.65 mmol/L. The blood calcium concentration is less than 2.00 mmol/L, hypocalcemia can be considered [12][13]. A blood calcium concentration of 1.90-2.00 mmol/L is considered mild hypocalcemia; blood calcium < 1.…”

Section: Observation Index and Postoperative Treatmentmentioning

confidence: 99%

Predictive value of parathyroid hormone levels for permanent hypoparathyroidism at different time points after papillary thyroid cancer surgery

Gao

Zhang

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose To investigate the relationship between parathyroid hormone (PTH) levels on day 1 after radical thyroid surgery for papillary carcinoma and permanent hypoparathyroidism (PHPP) and the predictive value of the relationship between them. Methods Eighty patients with papillary thyroid cancer who underwent total thyroidectomy and lymph node dissection in the central area admitted to the General Surgery Department of Gansu Provincial People’s Hospital from January 2021 to January 2022 were collected and analyzed. Patients were divided into hypoparathyroidism and normal parathyroid groups according to whether PHPP occurred after surgery, and the correlation between parathyroid hormone (PTH) and serum calcium levels and permanent hypoparathyroidism (PHPP) on postoperative day 1 in both groups was analyzed using univariate and binary logistics regression. The area under the subject operating curve (ROC) was used to assess the predictive validity of PTH for the occurrence of PHPP in the postoperative period. Results PHPP occurred in 10 of the 80 patients with papillary thyroid cancer included, with an incidence of 12.5%; binary logistic regression analysis showed that PTH on a postoperative day 1 (OR = 14.534, 95% CI: 2.377 to 88.858, P = 0.004), was an independent predictive risk factor for the development of PHPP after surgery. The area under the curve (AUC) was 0.874 (95% CI: 0.79–0.958, P = 0.000) with a sensitivity of 71.4%, specificity of 100%, and Jorden index of 0.714, using PTH = 8.75ng/L on postoperative day 1 as the threshold value. Conclusions PTH levels on day 1 after total thyroid papillary carcinoma are strongly associated with permanent hypoparathyroidism and are an independent predictor of the development of PHPP.

show abstract

Definition and diagnosis of postsurgical hypoparathyroidism after thyroid surgery: meta-analysis

et al. 2022

View full text Add to dashboard Cite

Background Postsurgical hypoparathyroidism (PH) is the most frequent complication after thyroid surgery. The aim of this systematic review and meta-analysis is to summarize a unifying definition of PH and to elucidate the best possible approach for early detection of PH. Methods A systematic review of the literature according to the PICO framework using Embase, PUBMED and the Cochrane library was carried out on 1 December 2021 followed by analysis for risk of bias, data extraction and meta-analysis. All studies addressing the definition of postoperative hypoparathyroidism and/or diagnostic approaches for early detection and diagnosis were included. Case reports, commentaries, non-English articles, book chapters and pilot studies and reviews were excluded. Results From 13 704 articles, 188 articles were eligible for inclusion and further analysis. These articles provided heterogeneous definitions of PH. Meta-analysis revealed that postoperative measurements of parathormone (PTH) levels have a higher sensitivity and specificity than intraoperative PTH measurements to predict PH after thyroid surgery. None of the timeframes analysed after surgery within the first postoperative day (POD1) was superior to predict the onset of PH. PTH levels of less than 15 pg/ml and less than 10 pg/ml are both reliable threshold levels to predict the postoperative onset of PH. A relative reduction of mean(s.d.) PTH levels from pre- to postoperative values of 73 (standard deviation 11) per cent may also be predictive for the development of PH. The estimation of calcium levels on POD1 are recommended. Conclusion PH is best defined as an undetectable or inappropriately low postoperative PTH level in the context of hypocalcaemia with or without hypocalcaemic symptoms. PTH levels should be measured after surgery within 24 h. Both threshold levels below 10 and 15 pg/ml or relative loss of PTH before/after thyroid surgery are reliable to predict the onset of PH.

show abstract

The role of early postoperative parathyroid hormone level after total thyroidectomy in prediction of hypocalcemia

Cited by 4 publications

References 17 publications

Delta parathormone value as an indicator of postoperative hypocalcemia in patients with parathyroid adenoma

Delta parathormone value as an indicator of postoperative hypocalcemia in patients with parathyroid adenoma

Predictive value of parathyroid hormone levels for permanent hypoparathyroidism at different time points after papillary thyroid cancer surgery

Definition and diagnosis of postsurgical hypoparathyroidism after thyroid surgery: meta-analysis

Contact Info

Product

Resources

About