Perioperative parathyroid hormone assay for diagnosis and management of postthyroidectomy hypocalcemia.
OBJECTIVE
The purpose of this study was to assess the relationship between perioperative changes in parathyroid hormone (PTH) level and the likelihood of postthyroidectomy hypocalcemia.


METHODS
In a series of 78 patients undergoing total or completion thyroidectomy, PTH levels were measured before surgery and at 10 minutes after removal of the thyroid gland.


METHODS
A prospective, nonrandomized collection of serum from 78 consecutive total or completion thyroidectomy procedures performed by a single surgeon was carried out over 18 months. Analysis is made of PTH levels, serum calcium values, need for calcium supplementation, and symptoms of hypocalcemia.


RESULTS
Both a PTH change of 75% and an absolute postoperative PTH of 7 pg/mL are accurate standards for predicting symptomatic hypocalcemia after total or completion thyroid surgery.


CONCLUSIONS
Perioperative PTH levels are a tool for the prediction of postoperative symptomatic hypocalcemia after thyroidectomy. A PTH level drawn 10 minutes after removal of the thyroid predicts the likelihood of postoperative hypocalcemia.
Scurry
W Cooper
WC
Division of Otolaryngology, Head and Neck Surgery, Penn State University College of Medicine, 600 University Drive, Hershey, PA 17033, USA.
Beus
Kirt S
KS
Hollenbeak
Christopher S
CS
Stack
Brendan C
BC
D000328:Adult; D017677:Age Distribution; D002118:Calcium / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000601:surgery; D006996:Hypocalcemia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000032:analysis / Q000378:metabolism*; D019990:Perioperative Care; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D017678:Sex Distribution; D013960:Thyroid Function Tests; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*
D010281:Parathyroid Hormone; D002118:Calcium