title: Applicability of immediate, late or serial intact parathyroid hormone measurement following total thyroidectomy.
abstract: Hypocalcemia is the most common complication after total thyroidectomy. Intact parathyroid hormone (i-PTH) testing is a proven effective method to detect patients at risk for postoperative symptomatic hypocalcemia. However, there is still uncertainty as to the timing of i-PTH testing in a clinical setting.
  
  
  OBJECTIVE
  This study looked into the correlation between serum i-PTH levels measured at different times after total thyroidectomy and the risk of symptomatic hypocalcemia.
  
  
  METHODS
  This retrospective case series studied a group of 110 consecutive for hypocalcemia and intact parathyroid hormone (PTHi) levels four and twelve hours following total thyroidectomy. Statistical analysis was used to evaluate the performance of isolated and serial i-PTH measurements to determine the likelihood of symptomatic hypocalcemia.
  
  
  RESULTS
  I-PTH is highly sensitive (90.3%-96.8%) and specific (77.2%-87.3%) for symptomatic hypocalcemia. There was no significant difference in the sensitivity levels of the tests done four and twelve hours after surgery or in a serial fashion. However, the 12-hour i-PTH level was more specific (p < 0.0007).
  
  
  CONCLUSIONS
  Single i-PTH testing done 12 hours after total thyroidectomy may be used as a screening test to detect patients at risk for symptomatic hypocalcemia.
authors.affiliation: Otorhinolaryngology and Head and Neck Surgery Department, São José Hospital, Joinville - SC, Brazil. 　agnaldograciano@yahoo.com.br
authors.forename: Agnaldo José
authors.initials: AJ
authors.lastname: Graciano
authors.forename: Carlos Takahiro
authors.initials: CT
authors.lastname: Chone
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Fischer
mesh_terms: D000465:Algorithms; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011184:Postoperative Period; D015203:Reproducibility of Results; D013965:Thyroidectomy / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D010281:Parathyroid Hormone