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Predictive value of postoperative day 1 parathyroid hormone levels for early and late hypocalcaemia after thyroidectomy.

dc.contributor.authorRiordan, Fiona
dc.contributor.authorBrophy, Catherine
dc.contributor.authorMurphy, Matthew S
dc.contributor.authorSheahan, Patrick
dc.date.accessioned2024-07-22T14:26:48Z
dc.date.available2024-07-22T14:26:48Z
dc.date.issued2022-03-05
dc.identifier.pmid35247092
dc.identifier.doi10.1007/s00423-022-02480-1
dc.identifier.urihttp://hdl.handle.net/10147/642401
dc.descriptionPurpose: Early parathyroid hormone (PTH) levels after total thyroidectomy can predict patients at low risk of hypocalcaemia who can be discharged early without calcium supplementation. For centres without facility to perform early PTH levels, PTH levels sent on the first postoperative day (POD1) may be an alternative. However, there is less data regarding optimal cut-off PTH levels for POD1 discharge. Methods: Retrospective review of prospective database of thyroid operations between September 2009 and February 2020 at tertiary referral centre. Main outcome measure was symptomatic hypocalcaemia. Results: Five hundred seventy patients undergoing total (521) or completion thyroidectomy with POD1 PTH levels available were included. Among patients with POD1 PTH levels ≥ 20 pg/ml and POD1 calcium ≥ 2.0 mmol/l, the incidence of symptomatic hypocalcaemia was 1% (3/300), and need for intravenous calcium 0.3% (1/300). For POD1 PTH levels 15-19 pg/ml and POD1 calcium ≥ 2.0 mmol/l, the incidence of symptomatic hypocalcaemia and need for intravenous calcium was 5.4% (3/55). For PTH levels 10-14 pg/ml and calcium ≥ 2.0 mmol/l, the incidence of symptomatic hypocalcaemia and need for intravenous calcium was 11.7% (7/60). The risk of permanent hypoparathyroidism was < 1% for POD1 PTH levels ≥ 15 pg/ml; 5.4% for levels 10-14 pg/ml; and 19.8% for levels < 10 pg/ml. Conclusions: POD1 PTH levels ≥ 15 pg/ml along with calcium ≥ 2.0 mmol/l are associated with low risk of symptomatic hypocalcaemia, and represent a safe criterion for discharge of most patients without calcium supplementation. For certain patient groups, a higher threshold of 20 pg/ml could be considered.en_US
dc.language.isoenen_US
dc.rights© 2022. The Author(s).
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectHypocalcemiaen_US
dc.subjectHypoparathyroidismen_US
dc.subjectParathyroid hormoneen_US
dc.subjectThyroidectomyen_US
dc.titlePredictive value of postoperative day 1 parathyroid hormone levels for early and late hypocalcaemia after thyroidectomy.en_US
dc.typeArticleen_US
dc.identifier.eissn1435-2451
dc.identifier.journalLangenbeck's archives of surgeryen_US
dc.source.journaltitleLangenbeck's archives of surgery
dc.source.volume407
dc.source.issue4
dc.source.beginpage1653
dc.source.endpage1658
refterms.dateFOA2024-07-22T14:26:50Z
dc.source.countryGermany


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