Abstract
Objectives/Hypothesis: An immediate method of accurately predicting postoperative hypocalcemia after total thyroidectomy would allow for selective early discharge of patients at low risk. The objective of the study was to determine the utility of perioperative parathyroid hormone measurement in predicting postoperative hypocalcemia after a thyroid surgery that places total parathyroid function at risk. Study Design: Prospective case series. Methods: Twenty-seven patients undergoing total or completion thyroidectomy had three blood samples drawn for parathyroid hormone measurement before dissection, 10 minutes after specimen removal, and in the recovery room. Serial ionized calcium levels were measured in the postoperative period. Preoperative, postresection, and recovery room levels were compared with postoperative ionized calcium levels. Results: The average values before resection, after resection, and in the recovery room were 69.3 (range, 13-163), 42.3 (range, 0-120), and 37.4 (range 7-79) pg/mL, respectively. The incidence of hypocalcemia was 11% (3 of 27 patients). The rate of hypocalcemia was significantly higher (50%) in patients with recovery room parathyroid hormone values of 10 pg/mL or less relative to patients with recovery room parathyroid hormone values greater than 10 pg/mL (4%) in this setting (P = .01). Among patients with a parathyroid hormone value of less than 15 pg/mL in the recovery room, an increasing parathyroid hormone level in the recovery room relative to the level after resection predicted normocalcemia without calcium supplementation on X2 analysis (P = .01). Conclusion: The study demonstrated that perioperative parathyroid hormone values can help predict patients who are at highest risk for postoperative hypocalcemia after thyroid surgery.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 689-693 |
| Number of pages | 5 |
| Journal | Laryngoscope |
| Volume | 114 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2004 |
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Keywords
- Hypocalcemia
- Parathyroid
- Parathyroid hormone assay
- Perioperative
- Thyroid
ASJC Scopus subject areas
- Otorhinolaryngology
Cite this
Perioperative Parathyroid Hormone Levels in Thyroid Surgery : Preliminary Report. / Warren, Frank M.; Andersen, Peter; Wax, Mark; Cohen, James.
In: Laryngoscope, Vol. 114, No. 4, 04.2004, p. 689-693.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Perioperative Parathyroid Hormone Levels in Thyroid Surgery
T2 - Preliminary Report
AU - Warren, Frank M.
AU - Andersen, Peter
AU - Wax, Mark
AU - Cohen, James
PY - 2004/4
Y1 - 2004/4
N2 - Objectives/Hypothesis: An immediate method of accurately predicting postoperative hypocalcemia after total thyroidectomy would allow for selective early discharge of patients at low risk. The objective of the study was to determine the utility of perioperative parathyroid hormone measurement in predicting postoperative hypocalcemia after a thyroid surgery that places total parathyroid function at risk. Study Design: Prospective case series. Methods: Twenty-seven patients undergoing total or completion thyroidectomy had three blood samples drawn for parathyroid hormone measurement before dissection, 10 minutes after specimen removal, and in the recovery room. Serial ionized calcium levels were measured in the postoperative period. Preoperative, postresection, and recovery room levels were compared with postoperative ionized calcium levels. Results: The average values before resection, after resection, and in the recovery room were 69.3 (range, 13-163), 42.3 (range, 0-120), and 37.4 (range 7-79) pg/mL, respectively. The incidence of hypocalcemia was 11% (3 of 27 patients). The rate of hypocalcemia was significantly higher (50%) in patients with recovery room parathyroid hormone values of 10 pg/mL or less relative to patients with recovery room parathyroid hormone values greater than 10 pg/mL (4%) in this setting (P = .01). Among patients with a parathyroid hormone value of less than 15 pg/mL in the recovery room, an increasing parathyroid hormone level in the recovery room relative to the level after resection predicted normocalcemia without calcium supplementation on X2 analysis (P = .01). Conclusion: The study demonstrated that perioperative parathyroid hormone values can help predict patients who are at highest risk for postoperative hypocalcemia after thyroid surgery.
AB - Objectives/Hypothesis: An immediate method of accurately predicting postoperative hypocalcemia after total thyroidectomy would allow for selective early discharge of patients at low risk. The objective of the study was to determine the utility of perioperative parathyroid hormone measurement in predicting postoperative hypocalcemia after a thyroid surgery that places total parathyroid function at risk. Study Design: Prospective case series. Methods: Twenty-seven patients undergoing total or completion thyroidectomy had three blood samples drawn for parathyroid hormone measurement before dissection, 10 minutes after specimen removal, and in the recovery room. Serial ionized calcium levels were measured in the postoperative period. Preoperative, postresection, and recovery room levels were compared with postoperative ionized calcium levels. Results: The average values before resection, after resection, and in the recovery room were 69.3 (range, 13-163), 42.3 (range, 0-120), and 37.4 (range 7-79) pg/mL, respectively. The incidence of hypocalcemia was 11% (3 of 27 patients). The rate of hypocalcemia was significantly higher (50%) in patients with recovery room parathyroid hormone values of 10 pg/mL or less relative to patients with recovery room parathyroid hormone values greater than 10 pg/mL (4%) in this setting (P = .01). Among patients with a parathyroid hormone value of less than 15 pg/mL in the recovery room, an increasing parathyroid hormone level in the recovery room relative to the level after resection predicted normocalcemia without calcium supplementation on X2 analysis (P = .01). Conclusion: The study demonstrated that perioperative parathyroid hormone values can help predict patients who are at highest risk for postoperative hypocalcemia after thyroid surgery.
KW - Hypocalcemia
KW - Parathyroid
KW - Parathyroid hormone assay
KW - Perioperative
KW - Thyroid
UR - http://www.scopus.com/inward/record.url?scp=1842610137&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=1842610137&partnerID=8YFLogxK
U2 - 10.1097/00005537-200404000-00017
DO - 10.1097/00005537-200404000-00017
M3 - Article
VL - 114
SP - 689
EP - 693
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 4
ER -