title: Post-operative parathyroid hormone can be used as a predictor of normocalcaemia after total thyroidectomy.
abstract: BACKGROUND
  Development of hypocalcaemia is a serious complication to total thyroidectomy (TT). The measurement of intact plasma parathyroid hormone (iPTH) has been internationally described as a good predictor of hypocalcaemia. Despite this, consensus in the field has yet to be reached among clinicians. We aimed to evaluate if measurement of iPTH 24 hours post-operatively (24-iPTH) can identify patients who do not subsequently develop clinically significant hypocalcaemia (CSH), thereby allowing for early discharge after TT.
  
  
  METHODS
  This was a historic cohort study of all patients who had a TT in the period from January 2013 to March 2014 at the Department of Oto-rhino-laryngology, Aarhus University Hospital, Denmark. Only patients with 24-iPTH measurements were included. Post-operative treatment with calcium or activated vitamin D analogue was defined as CSH. Data were collected from medical records.
  
  
  RESULTS
  A total of 69 patients were included, 80% were women, the median age was 47 and 83% had a malignant disease. A total of 35% developed CSH and the median hospitalisation period was four days. The sensitivity, specificity and positive predictive value of 24-iPTH ≥ 2.8 pmol/l to exclude CSH were 76%, 92% and 94%, respectively. In addition, we found that a body mass index > 25 kg/m(2) significantly increased the risk of developing CSH.
  
  
  CONCLUSIONS
  The measurement of 24-iPTH ≥ 2.8 pmol/l can be used to predict patients who will not develop CSH after TT and allow for early discharge of more than 50% of the patients.
  
  
  BACKGROUND
  none.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: chadi.abdelhalim@gmail.com.
authors.forename: Chadi Nimeh
authors.initials: CN
authors.lastname: Abdel-Halim
authors.forename: Lars
authors.initials: L
authors.lastname: Rejnmark
authors.forename: Viveque Egsgaard
authors.initials: VE
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood*; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012307:Risk Factors; D013965:Thyroidectomy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium