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Postoperative PTH Measurement as a Predictor of Hypocalcaemia After Thyroidectomy

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Proczko-Markuszewska M., Kobiela J., Stefaniak T., Łachiński A., Śledziński Z.
Polish Journal of Surgery
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2010
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vol. 82
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issue 1
24-28
EN
Hypocalcemia after thyroidectomy is the most common postoperative complication with reported incidence from 0.5% to even half of the operated patients. Hypoparathyroidism could be a result of careless or inadequate preparation during the surgical procedure. There is a variety of proposed options for prediction of the incidence of hypocalcemia. The most effective of them are the perioperative and intraoperative measurements of PTH level.The aim of the study was to assess the potential correlation between the iPTH levels after the operation and development of hypocalcaemia. The possible prediction value of postoperative iPTH levels was to be evaluated assessed.Material and methods. A prospective study was performed on 100 patients who underwent total thyroidectomy from January 2007 to June 2009. The total calcium level and intact human PTH (iPTH) levels were measured 24 hours before, 1 and 24 hours after the surgery.Results. We have presented a significant correlation between early iPTH measurement and risk of hypocalcaemia. Moreover a significant correlation between the iPTH level 1 hour after operation with the calcium level 24 hours after the operation was demonstrated.Conclusions. Early postoperative assessment of iPTH levels can be used to identify the group of patients at risk of hypocalcaemia after thyroidectomy. Pre-emptive calcium supplementation can lead to avoidance of complications causing prolonged hospital stay and most importantly to prevent severe hypocalcemia.
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