title: Effectiveness of an i-PTH measurement in predicting post thyroidectomy hypocalcemia: prospective controlled study.
abstract: OBJECTIVE
  Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia.
  
  
  METHODS
  We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively.
  
  
  RESULTS
  108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point.
  
  
  CONCLUSIONS
  We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy.
authors.affiliation: Department of Otorhinolaryngology, Gyeongsang National University, 79 Gangnam-ro, Jinju 660-702, Korea.
authors.forename: Jin Pyeong
authors.initials: JP
authors.lastname: Kim
authors.forename: Jung Je
authors.initials: JJ
authors.lastname: Park
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Son
authors.forename: Rock Bum
authors.initials: RB
authors.lastname: Kim
authors.forename: Ho Youp
authors.initials: HY
authors.lastname: Kim
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Woo
mesh_terms: D002118:Calcium / Q000097:blood; D006801:Humans; D006996:Hypocalcemia / Q000175:diagnosis*; D008274:Magnesium / Q000097:blood; D016017:Odds Ratio; D010281:Parathyroid Hormone / Q000097:blood*; D010710:Phosphates / Q000097:blood; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D011446:Prospective Studies; D012709:Serum Albumin; D013965:Thyroidectomy / Q000009:adverse effects*
chemical_list: C470125:PTH protein, human; D010281:Parathyroid Hormone; D010710:Phosphates; D012709:Serum Albumin; D008274:Magnesium; D002118:Calcium
keywords: Thyroidectomy; hypocalcemia; parathyroid hormone; surgery
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