Reliable Early Prediction for Different Types of Post-Thyroidectomy Hypocalcemia
Clinical and Experimental Otorhinolaryngology
;
: 95-100, 2011.
Article
in English
| WPRIM
| ID: wpr-70192
ABSTRACT
OBJECTIVES:
High incidence of hypocalcemia after thyroidectomy is a major determinant in delay of discharge. Even though many studies have focused on the search for reliable early predictors of postoperative hypocalcemia, definitions of hypocalcemia are diverse; therefore, interpretation and application of previously reported findings may not be easy. We aimed to elucidate diverse patterns of post-thyroidectomy hypocalcemia and to provide reliable early predictors for these different types of hypocalcemia.METHODS:
Retrospective chart review was performed and eligible 112 patients of thyroidectomy were categorized into four groups according to symptomatic and/or biochemical hypocalcemic criteria. A mismatch of occurrence and the timing of symptomatic or biochemical abnormalities were evaluated. Predictive values of commonly used biomarkers were compared in each group; levels of serum total calcium and ionized calcium, and intact parathyroid hormone (PTH).RESULTS:
Among 62 hypocalcemic patients, 45 patients (72.5%) experienced both symptomatic and biochemical abnormalities during hospitalization. A mismatch on the timing of initial detection of symptomatic and biochemical hypocalcemia was observed in 21 patients (46.6%). Intact PTH level measured at 1 hour was a useful indicator in prediction of symptomatic hypocalcemia with 79.7-87.4% of diagnostic accuracy. Serum ionized calcium measured next morning after surgery was a reliable predictor of biochemical hypocalcemia with 77.9-94.8% of diagnostic accuracy.CONCLUSION:
For the safety of patients, the possibility of both symptomatic and biochemical hypocalcemia should be considered together before deciding early discharge. Using intact PTH for symptomatic hypocalcemia and day-1 ionized serum calcium level for biochemical hypocalcemia will be helpful for the reliable prediction of heterogeneous nature of postoperative hypocalcemia.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Parathyroid Hormone
/
Thyroidectomy
/
Biomarkers
/
Calcium
/
Incidence
/
Retrospective Studies
/
Early Diagnosis
/
Hospitalization
/
Hypocalcemia
Type of study:
Diagnostic study
/
Incidence study
/
Observational study
/
Prognostic study
/
Screening study
Limits:
Humans
Language:
English
Journal:
Clinical and Experimental Otorhinolaryngology
Year:
2011
Type:
Article
Similar
MEDLINE
...
LILACS
LIS