title: Hypocalcemia following total thyroidectomy: early factors predicting long-term outcome.
abstract: Hypocalcemia following total thyroidectomy (TT) must be considered permanent in patients requiring calcium replacement after one year. The aim of this study was to identify early risk factors predicting long-term outcome of postoperative hypocalcemia. Among 453 patients who underwent TT from January 1998 to May 2003, a cross-sectional study between 44 patients with transient hypocalcemia (9.7%) and 3 patients with permanent hypocalcemia (0.7%) was carried out. Both low serum calcium level (< 8 mg/dl) and high serum phosphorus level (> 4.5 mg/dl), measured on postoperative day 7, were predictive for outcome. Central neck lymph node dissection, performed for thyroid carcinoma, also correlated with outcome. Serum phosphorus level > 4.5 mg/dl on postoperative day 7 resulted the only independent factor predicting permanent hypoparathyroidism. Therefore indication for central dissection would be very strict. When serum phosphorus level is unfavorable a correct replacement therapy is mandatory to prevent the consequences of permanent hypocalcemia.
authors: Dipartimento Chirurgico, Materno-lnfantile e di Scienze dell'Immagine, Università degli Studi di Cagliari.
authors: A
authors: A
authors: Pisanu
authors: S
authors: S
authors: Piu
authors: A
authors: A
authors: Cois
authors: A
authors: A
authors: Uccheddu
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000188:drug therapy / Q000209:etiology*; D007011:Hypoparathyroidism / Q000150:complications* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013964:Thyroid Neoplasms / Q000601:surgery; D013965:Thyroidectomy / Q000009:adverse effects*