Purpose

Hypocalcemia linked to a diminished circulating intact parathormone (iPTH) is the most common complication after total thyroidectomy. The objective of this study was to evaluate iPTH as a predictor of post-thyroidectomy hypocalcemia.

Methods

Hundred-and-eight patients who underwent total thyroidectomy were included. Blood samples (iPTH, calcium and albumin) were performed at different times: preoperatively (H₀), after removal of the gland (H_drop), 6 h (H₆) and one day (D₁) after the surgery. Hypocalcemia was defined by total calcium corrected by serum albumin ≤ 2.10 mmol/l. The area under the ROC curve (AUC) was used to determine the best cut-off value and predictability of iPTH for hypocalcemia in terms of absolute value (ng/L), decrease in the slope (ng/L) and decline (%) between two times.

Results

The study included 101 patients. Among them, 39 had hypocalcemia (38.6%). At H₆, an iPTH absolute value less than 14.35 ng/L (Se = 0.706; Sp = 0.917) and a decline from the preoperative time of more than 59.5% (Se = 0.850; Sp = 0.820) were predictive of hypocalcemia. Other absolute values, decrease in the sloop and decline between preoperative and postoperative values were less relevant.

Conclusion

The iPTH 6 h after total thyroidectomy is predictive of hypocalcemia. It might be used to identify patients not at risk of hypocalcemia and earlier discharge could be considered.

中文翻译：

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在甲状腺切除术后 H6 使用甲状旁腺激素检测：低钙血症的早期预测指标

目的

与循环完整甲状旁腺素 (iPTH) 减少相关的低钙血症是甲状腺全切除术后最常见的并发症。本研究的目的是评估 iPTH 作为甲状腺切除术后低钙血症的预测因子。

方法

包括 18 名接受甲状腺全切除术的患者。在不同时间进行血样（iPTH、钙和白蛋白）：术前（H ₀）、腺体切除后（H _drop）、术后 6 小时（H ₆）和一天（D ₁）。低钙血症定义为血清白蛋白校正后的总钙≤2.10 mmol/l。ROC 曲线下面积 (AUC) 用于确定 iPTH 在绝对值 (ng/L)、斜率下降 (ng/L) 和下降 (%) 方面的最佳截断值和低钙血症可预测性两次之间。

结果

该研究包括 101 名患者。其中低钙血症39人（38.6%）。在 H ₆时，iPTH 绝对值小于 14.35 ng/L (Se = 0.706; Sp = 0.917) 和术前时间下降超过 59.5% (Se = 0.850; Sp = 0.820) 预示着低钙血症。其他绝对值、sloop 的减少以及术前和术后值之间的下降相关性较小。

结论

甲状腺全切除术后 6 小时的 iPTH 预示着低钙血症。它可能用于识别没有低钙血症风险的患者，并且可以考虑提前出院。