| Accuracy of postthyroidectomy parathyroid hormone and corrected calcium levels as early predictors of clinical hypocalcemia. | |
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MedLine Citation:
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PMID: 20642997 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the accuracy of measurement of different parathyroid hormone (PTH) and corrected calcium (cCa) levels at different times as early predictors of postthyroidectomy hypocalcemia. DESIGN: A retrospective cohort study. SETTING: King Fahad Medical City, Riyadh, Saudi Arabia, between January 2006 and March 2009. METHODS: Patients who underwent total or completion thyroidectomy were followed until hospital discharge. Patients were observed clinically for hypocalcemia; at the same time, the postoperative PTH and cCa levels after 6, 12, and 20 hours and then twice daily were recorded. MAIN OUTCOME MEASURES: Postthyroidectomy hypocalcemia. RESULTS: Seventy-nine of 116 patients were enrolled in our study; 26.60% of them had hypocalcemia. PTH measurement at 6 hours postoperatively was an excellent predictor of hypocalcemia (area under the curve = 0.95, 95% CI 0.88-0.99). The mean PTH at 6 hours for hypocalcemic patients was 0.93 (+/- 0.60). A 1.7 pmol/L as a cutoff level of PTH at 6 hours has 95.2% sensitivity, 89.7% specificity, 76.9% positive predictive value (PPV), and 98.1% negative predictive value (NPV). On the other hand, a 2.1 mmol/L as a cutoff level of cCa has 81.0% sensitivity, 81.6% specificity, 65.3% PPV, and 90.9% NPV in predicting hypocalcemic patients. CONCLUSIONS: PTH measurement 6 hours after surgery with a cutoff level of 1.7 pmol/L is more accurate than serial calcium level measurement for early prediction of patients at risk of hypocalcemia. Thus, a single PTH measurement postoperatively will help in discharging patients safely within the first 24 hours, improving bed use and cost-effective care. |
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Authors:
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Saleh Fahad Al-Dhahri; Yazeed A Al-Ghonaim; Abdullah Sulieman Terkawi |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale Volume: 39 ISSN: 1916-0216 ISO Abbreviation: J Otolaryngol Head Neck Surg Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-20 Completed Date: 2010-11-04 Revised Date: 2013-04-10 |
Medline Journal Info:
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Nlm Unique ID: 101479544 Medline TA: J Otolaryngol Head Neck Surg Country: Canada |
Other Details:
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Languages: eng Pagination: 342-8 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, King Fahad Medical City, Riyadh, Saudi Arabia. saldhahri@kfmc.med.sa |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Calcium / blood* Female Follow-Up Studies Humans Hypocalcemia / blood, diagnosis*, etiology Male Middle Aged Parathyroid Hormone / blood* Postoperative Period Prognosis Reproducibility of Results Retrospective Studies Thyroid Diseases / surgery Thyroidectomy / adverse effects* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Parathyroid Hormone; 7440-70-2/Calcium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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