title: Early prediction of symptomatic hypocalcemia after total thyroidectomy.
abstract: BACKGROUND
  Hypocalcemia is the most common postoperative complication after total thyroidectomy. The aim of this prospective study was to determine biochemical parameters in the early postoperative period that could identify patients with significantly increased risk of symptomatic hypocalcemia development.
  
  
  METHODS
  The study included 100 individuals undergoing total thyroidectomy from January to May 2009. In all patients PTH, calcium, inorganic phosphate, magnesium, and albumin levels were measured immediately preoperatively, 30 minutes postoperatively and every morning for the following five days.
  
  
  RESULTS
  Clinically significant hypocalcemia was observed in 19% of all cases. Fall of the iPTH values by more than 88% from preoperative values, 30 min after completion of the surgery, showed 100% sensitivity and 100% specificity for the occurrence of symptomatic hypocalcemia.
  
  
  CONCLUSIONS
  According to our results immediate postoperative measurement of the iPTH may be considered as a useful method to predict with high certainty which patients will need calcium supplementation, and to separate them from patients who can be safely and early discharged.
authors.affiliation: KBC Zvezdara University Medical Centre, Clinic for Surgery "Nikola Spasic", Belgrade, Serbia. bkzvez@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: Kovacevic
authors.forename: M
authors.initials: M
authors.lastname: Ignjatovic
authors.forename: V
authors.initials: V
authors.lastname: Cuk
authors.forename: V
authors.initials: V
authors.lastname: Zivaljevic
authors.forename: I
authors.initials: I
authors.lastname: Paunović
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013965:Thyroidectomy / Q000009:adverse effects*
chemical_list: D010281:Parathyroid Hormone