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Use of the parathyroid hormone assay at H6 post thyroidectomy: an early predictor of hypocalcemia

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Abstract

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 (Hdrop), 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.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, University Hospital of Brest, 4, av Foch, 29200, Brest, France

    C. Lacroix, G. Potard, J. Prévot, R. Marianowski & J.-C. Leclere

  2. Department of Head and Neck Surgery, Cochin University Hospital, Paris, France

    C. Lacroix

  3. Department of Endocrinology, University Hospital of Brest, Brest, France

    P. Thuillier & N. Roudaut

  4. Department of Nuclear Medicine, University Hospital of Brest, Brest, France

    R. Le Pennec

Authors
  1. C. Lacroix
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  2. G. Potard
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  3. P. Thuillier
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  4. R. Le Pennec
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  5. J. Prévot
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  6. N. Roudaut
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  7. R. Marianowski
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  8. J.-C. Leclere
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Correspondence to J.-C. Leclere.

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The research has been approved by the ethics committee.

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All patients gave written consent for the study.

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Lacroix, C., Potard, G., Thuillier, P. et al. Use of the parathyroid hormone assay at H6 post thyroidectomy: an early predictor of hypocalcemia. J Endocrinol Invest 45, 1–8 (2022). https://doi.org/10.1007/s40618-021-01601-9

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  • DOI: https://doi.org/10.1007/s40618-021-01601-9

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