Optimal time for measuring parathormone as a predictor of hypocalcemia after total thyroidectomy
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Introduction: Hypocalcemia after total thyroidectomy is a common complication in thyroid surgery. Parathyroid hormone has been shown to be a reliable predictor to detect patients with a high risk of significant hypocalcemia and the consequent need for calcium supplementation. This study sought to determine the optimum time or measurement of parathyroid hormone for this purpose.
Methods: A prospective study conducted in two institutions from April 2016 to February 2018, in which pre- surgical parathormone levels were measured at 0, 2, 4, and 12 hours post-operatively, comparing them with the values obtained at 3 months of follow-up in patients undergoing total thyroidectomy, taking into account as risk groups and in need of calcium supplementation a parathormone value <10 pg / ml or a decrease > 80% with respect to the pre- surgical level.
Results: 34 patients operated on, the parathormone sample at 4 hours it was sensitive and specific (60 and 93.1% respectively) taking as threshold a value <10 pg / ml and a decrease> 80% with respect to a presurgical level (60 and 96.5% respectively) , the latter presenting a positive predictive value of 75% and negative of 93.3% with a p <0.001.
Conclusion: A >80% decrease in parathormone at 4 hours with respect to its presurgical value, predicts those patients with a high risk of significant hypocalcemia who require early calcium supplementation. compared to the determination of the decrease at 0, 2 and 12 hours.
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