Preoperative PTH as a marker of risk for post-thyroidectomy hypocalcemia.
OBJECTIVE
There are no common guidelines to identify the population at risk to develop hypocalcemia preoperatively or early in the postoperative course in thyroidectomized patients, therefore the authors suggest to examine the PTH value preoperatively.


METHODS
We divided 391 patients in two groups according to the preoperative PTH level (normal, ≤ 72 pg/mL vs. increased >73 pg/mL).


RESULTS
In 92/391 cases (23.52%) preoperative PTH was increased (mean PTH level 112.4+/-24.8 pg/mL; normal range 12-72 pg/mL). Out of these, 43 (46.7%) had hypocalcaemia postoperatively. In 18 out of the 43 patients clinical hypocalcemia also developed. The mean follow-up was of 148+/-13 days. Of the 299 patients with normal preoperative PTH, 127 (42.47%) developed postoperative hypocalcemia (mean calcium level 7.4+/-0.33 mg/dL). In 30 patients it was also clinically evident. The difference in terms of incidence of symptomatic hypocalcemia was statistically significant (increased preoperative PTH 19.5% vs. normal preoperative PTH 10.03% , P=0.036).


CONCLUSIONS
All candidates to thyroidectomy should be investigated for preoperative PTH abnormalities.
Del Rio
P
P
Department of Surgical Science, General Surgery and Organ Transplantation, Parma University Hospital, Parma, Italy. paolo.delrio@unipr.it
Sommaruga
L
L
Bezer
L
L
Arcuri
M F
MF
Cataldo
S
S
Ceresini
G
G
Sianesi
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006996:Hypocalcemia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010280:Parathyroid Glands / Q000293:injuries; D010281:Parathyroid Hormone / Q000097:blood*; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013959:Thyroid Diseases / Q000097:blood* / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*
D015415:Biomarkers; D010281:Parathyroid Hormone