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2016 ; 5
(5
): 522-528
Nephropedia Template TP
gab.com Text
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English Wikipedia
Early intact PTH (iPTH) is an early predictor of postoperative hypocalcemia for a
safer and earlier hospital discharge: an analysis on 260 total thyroidectomies
#MMPMID27867867
Inversini D
; Rausei S
; Ferrari CC
; Frattini F
; Anuwong A
; Kim HY
; Liu X
; Wu CW
; Tian W
; Liu R
; Dionigi G
Gland Surg
2016[Oct]; 5
(5
): 522-528
PMID27867867
show ga
BACKGROUND: Hypocalcemia is the most frequent complication after thyroidectomy.
Serum calcium levels are reliable only 48-72 hours postoperatively. Early intact
PTH (iPTH) has been proposed as early predictor of postoperative hypocalcemia.
Our aim is to assess the ability of iPTH in predicting postoperative
hypocalcemia. METHODS: Two hundred and sixty patients underwent thyroidectomy
with postoperative iPTH evaluation. The iPTH samplings were early performed after
thyroidectomy. The calcium levels were dosed postoperatively. Age, sex, clinical
diagnosis, obesity, comorbidities, previous neck surgery, preoperative therapy,
type of surgery, dissectors used, lymphadenectomy, post-operative complications,
reoperation and histological diagnosis were considered. The primary end-point was
the postoperative hospital stay. The secondary end-points were serum calcium and
iPTH. Three iPTH cut-offs were tested to assess which was the best value (10.0,
15.0, and 20.0 pg/mL). RESULTS: The iPTH cut-off value of 10.0 pg/mL was the most
accurate and specific for hypocalcemia. Comparing the iPTH value with the
different values of calcium respectively 24 and 48 hours after surgery, a
statistically stronger association with the serum calcium levels 48 hours
postoperatively has been shown. iPTH ?10 pg/mL 3-6 hours after surgery was
strongly correlated to early discharge. CONCLUSIONS: The correlation of iPTH with
hypocalcemia is significant since a few hours after surgery and the value of iPTH
?10 pg/mL is able to select those patients for a safe and early discharge. The
use of the iPTH might avoid unnecessary extensions of hospitalization.