Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy?
Introduction: Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. The current study aimed at evaluating the comparative predictive role of serum calcium a...
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Mashhad University of Medical Sciences
2017-09-01
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| Series: | Iranian Journal of Otorhinolaryngology |
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| Online Access: | http://ijorl.mums.ac.ir/article_9217_36b0742b15d93eee182380b94edf7d88.pdf |
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| author | Mohsen Kolahdouzan Shahab Shahabi Shahmiri Seyed Mozafar Hashemi Behrouz Kaleydari Masoud Nazem Rastin Mohammadi Mofrad |
| author_facet | Mohsen Kolahdouzan Shahab Shahabi Shahmiri Seyed Mozafar Hashemi Behrouz Kaleydari Masoud Nazem Rastin Mohammadi Mofrad |
| author_sort | Mohsen Kolahdouzan |
| collection | DOAJ |
| description | Introduction: Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. The current study aimed at evaluating the comparative predictive role of serum calcium and intact parathyroid hormone (iPTH) for post-thyroidectomy hypocalcemia. Materials and Methods: This prospective study was performed in 83 consecutive patients undergoing total thyroidectomy. Laboratory data such as serum calcium, vitamin D level, serum iPTH and serum phosphorus levels before surgery, postoperative calcium, and PTH levels measured after 1 and 6 hours and on the first postoperative day (1POD) were recorded. Results: Among the 83 patients, the mean (SD) age was 45.87 (12.57) years (range, 21–72 years); 70 (84.3%) patients were female. Final pathology was benign for 47 (56.6%) patients and malignant for 36 (43.4%) patients. In total, lymph node dissections were performed in 19 subjects (22.9%). On histological examination of the specimens, the parathyroid gland was found to have been removed inadvertently in 13 (15.7%) cases. In total, 35 (40.9%) patients developed hypocalcemia after thyroidectomy; receiver operating characteristic (ROC) analysis showed that a cut-off value of 15.39 pg/ml for iPTH, with a decline rate of 73% 1 hour after thyroidectomy is a significant predictor of hypocalcemia (area under the curve [AUC], 0.878; 95% confidence interval [CI], 0.79–0.96, P |
| first_indexed | 2024-12-23T21:16:58Z |
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| issn | 2251-7251 2251-726X |
| language | English |
| last_indexed | 2024-12-23T21:16:58Z |
| publishDate | 2017-09-01 |
| publisher | Mashhad University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Otorhinolaryngology |
| spelling | doaj.art-9686d39874ea445f89bc39e1952025612022-12-21T17:30:52ZengMashhad University of Medical SciencesIranian Journal of Otorhinolaryngology2251-72512251-726X2017-09-0129523924610.22038/ijorl.2017.21685.17259217Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy?Mohsen Kolahdouzan0Shahab Shahabi Shahmiri1Seyed Mozafar Hashemi2Behrouz Kaleydari3Masoud Nazem4Rastin Mohammadi Mofrad5Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Introduction: Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. The current study aimed at evaluating the comparative predictive role of serum calcium and intact parathyroid hormone (iPTH) for post-thyroidectomy hypocalcemia. Materials and Methods: This prospective study was performed in 83 consecutive patients undergoing total thyroidectomy. Laboratory data such as serum calcium, vitamin D level, serum iPTH and serum phosphorus levels before surgery, postoperative calcium, and PTH levels measured after 1 and 6 hours and on the first postoperative day (1POD) were recorded. Results: Among the 83 patients, the mean (SD) age was 45.87 (12.57) years (range, 21–72 years); 70 (84.3%) patients were female. Final pathology was benign for 47 (56.6%) patients and malignant for 36 (43.4%) patients. In total, lymph node dissections were performed in 19 subjects (22.9%). On histological examination of the specimens, the parathyroid gland was found to have been removed inadvertently in 13 (15.7%) cases. In total, 35 (40.9%) patients developed hypocalcemia after thyroidectomy; receiver operating characteristic (ROC) analysis showed that a cut-off value of 15.39 pg/ml for iPTH, with a decline rate of 73% 1 hour after thyroidectomy is a significant predictor of hypocalcemia (area under the curve [AUC], 0.878; 95% confidence interval [CI], 0.79–0.96, Phttp://ijorl.mums.ac.ir/article_9217_36b0742b15d93eee182380b94edf7d88.pdfHypocalcemiaParathyroid hormoneThyroidectomy |
| spellingShingle | Mohsen Kolahdouzan Shahab Shahabi Shahmiri Seyed Mozafar Hashemi Behrouz Kaleydari Masoud Nazem Rastin Mohammadi Mofrad Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy? Iranian Journal of Otorhinolaryngology Hypocalcemia Parathyroid hormone Thyroidectomy |
| title | Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy? |
| title_full | Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy? |
| title_fullStr | Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy? |
| title_full_unstemmed | Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy? |
| title_short | Is Decline Rate of Intact Parathyroid Hormone Level a Reliable Criterion for Early Discharge of Patients after Total Thyroidectomy? |
| title_sort | is decline rate of intact parathyroid hormone level a reliable criterion for early discharge of patients after total thyroidectomy |
| topic | Hypocalcemia Parathyroid hormone Thyroidectomy |
| url | http://ijorl.mums.ac.ir/article_9217_36b0742b15d93eee182380b94edf7d88.pdf |
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