title: Predictive value of age and serum parathormone and vitamin d3 levels for postoperative hypocalcemia after total thyroidectomy for nontoxic multinodular goiter.
abstract: OBJECTIVE
  Age, postoperative serum parathormone (PTH) level, and preoperative serum 25-hydroxyvitamin D(3) (25-OHD) level predict postoperative hypocalcemia after total thyroidectomy.
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  One hundred thirty patients with nontoxic multinodular goiter. Patients were divided into 2 groups according to the postoperative serum calcium level. Group 1 (n = 32) consisted of patients with a postoperative serum calcium level of 8 mg/dL or less, and group 2 (n = 98) consisted of patients with a postoperative serum calcium level higher than 8 mg/dL.
  
  
  METHODS
  The preoperative serum 25-OHD level and preoperative and postoperative serum calcium and PTH levels were determined.
  
  
  METHODS
  The number of patients developing hypocalcemia and prediction of postoperative hypocalcemia by the serum 25-OHD and PTH levels.
  
  
  RESULTS
  Hypocalcemia developed in 32 patients (24.6%) (group 1). The preoperative serum 25-OHD level and postoperative serum calcium and PTH levels in group 1 were significantly lower than in group 2 (P = .001). With logistic regression analysis, factors that were predictive of postoperative hypocalcemia included a preoperative serum 25-OHD level less than 15 ng/mL (P < .001; odds ratio, 558.5), a postoperative serum PTH level less than 10 pg/mL (P = .01; odds ratio, 16.4), and being older than 50 years (P = .01; odds ratio, 4.6).
  
  
  CONCLUSIONS
  Age, a low preoperative serum 25-OHD level, and a low postoperative serum PTH level are significantly associated with postoperative hypocalcemia. The low preoperative serum 25-OHD level was more significant than the low postoperative serum PTH level in the prediction of postoperative hypocalcemia.
authors: Department of General Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey.
authors: Yesim
authors: Y
authors: Erbil
authors: Alp
authors: A
authors: Bozbora
authors: Nese
authors: N
authors: Ozbey
authors: Halim
authors: H
authors: Issever
authors: Feríhan
authors: F
authors: Aral
authors: Selçuk
authors: S
authors: Ozarmagan
authors: Serdar
authors: S
authors: Tezelman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002762:Cholecalciferol / Q000097:blood*; D005260:Female; D006044:Goiter, Nodular / Q000097:blood / Q000601:surgery*; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013965:Thyroidectomy / Q000009:adverse effects*
chemical_list: D010281:Parathyroid Hormone; D002762:Cholecalciferol