Reliable Early Prediction for Different Types of Post-Thyroidectomy Hypocalcemia
Clinical and Experimental Otorhinolaryngology
; : 95-100, 2011.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-70192
Biblioteca responsável:
WPRO
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.
Texto completo:
Disponível
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Hormônio Paratireóideo
/
Tireoidectomia
/
Biomarcadores
/
Cálcio
/
Incidência
/
Estudos Retrospectivos
/
Diagnóstico Precoce
/
Hospitalização
/
Hipocalcemia
Tipo de estudo:
Estudo diagnóstico
/
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Estudo de rastreamento
Limite:
Humanos
Idioma:
Inglês
Revista:
Clinical and Experimental Otorhinolaryngology
Ano de publicação:
2011
Tipo de documento:
Artigo