Document Detail


Accuracy of postthyroidectomy parathyroid hormone and corrected calcium levels as early predictors of clinical hypocalcemia.
MedLine Citation:
PMID:  20642997     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Saleh Fahad Al-Dhahri; Yazeed A Al-Ghonaim; Abdullah Sulieman Terkawi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
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:
Created Date:  2010-07-20     Completed Date:  2010-11-04     Revised Date:  2013-04-10    
Medline Journal Info:
Nlm Unique ID:  101479544     Medline TA:  J Otolaryngol Head Neck Surg     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  342-8     Citation Subset:  IM    
Affiliation:
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:
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:
0/Parathyroid Hormone; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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