Delta calcium as a reliable predictor of early post thyroidectomy hypocalcemia for early safe discharge

  • Background
    Hypocalcaemia is the most common complication after total thyroidectom.
    The aim of our study was to assess sensitivity and specificity of delta calcium (? Ca = preoperative Ca – 20h postoperative Ca ) in early prediction of post thyroidectomy hypocalcemia.

    Methods
    The study included 116 patients who were subjected to total or completion thyroidectomy. Postoperative corrected serum calcium levels were measured at 6, 20 and 48 hours, hypocalcemia was defined as Ca level below 8.4 mg/dl at any time point and/or patient experiencing symptoms of hypocalcaemia. Ca levels and their differences between time points were compared. All hypocalcaemic patients were followed up at one and 6 months post-operatively.

    Results
     
    26 patients (22.4%) developed postoperative hypocalcaemia. The ? Ca (preoperative ca – 20h postoperative ca) had the best area under the ROC curves (AUC = 0.87), and ? Ca (>0.5) was significantly more frequent in cases of hypocalcemia (p < 0.001) with 80.77 % sensitivity and 77.78 % specificity. In our study the ? Ca (preoperative ca – 6h postoperative ca) was significant if ? Ca (>0.3) with (AUC = 0.82) and (p < 0.001) with 92.3% sensitivity and 63.3 % specificity.

    Conclusions
    The ? Ca enabled us for early detection of patients with post thyroidectomy hypocalcaemia, and it can be a useful and cost-effective tool for early, safe discharge.

 

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