Morales CM, Lazo JP

Language: Spanish
References: 10
Page: 90-95
PDF size: 473.64 Kb.

ABSTRACT

Objective: To compare the management of patients after thyroid and parathyroid surgery, followed with calcium serum levels at 6 and 12 hours and parathyroid hormone levels within the first 24 hours after surgery, in the prediction of early symptomatic hypocalcemia, in order to reduce the number of days of hospital stay.
Material and method: Clinical, retrospective, analytical and transverse study of 77 patients who underwent thyroid and parathyroid surgery. Patients were incorporated in two protocols: the first one was monitored with calcium serum levels registered 6 and 12 hours after surgery. The second one with parathyroid hormone levels within the first 24 hours after surgery.
Results: A total of 22 (28.5%) patients developed symptomatic hypocalcemia after surgery, nine in the parathyroid hormone group and 13 in the group evaluated with calcium levels. The global accuracy for the first test was 81%, sensitivity and specificity of 81%. For the second group, 66%, 50% and 90% respectively. The average number of hospital stay days for both groups was 3.6.
Conclusion: Monitoring with calcium levels at 6 and 12 hours allows an adequate determination of the patients who will develop symptomatic hypocalcemia, obtaining parathyroid hormone levels detects accurately those patients with symptomatic hypocalcemia in case they are low, nevertheless it has suboptimal sensitivity. There was no difference between both groups in the number of hospital stay days.

REFERENCES

1. Husein M, Hier MP, Al-Abdulhadi K, Black M. Predicting calcium status post thyroidectomy with early calcium levels. Otolaryngol Head Neck Surg 2002;127:289-293.

2. Díez A, Sánchez L, Sánchez-Seco P. Determinación de paratirina en suero como factor predictivo de hipocalcemia tras tiroidectomía total. Cir Esp 2009;85:96-102.

3. Morales C, Zubiaur-Gomar F. Predicción de concentraciones de calcio en pacientes posoperados de cirugía de tiroides y paratiroides con base en el calcio sérico del posoperatorio mediato. An Orl Mex 2005;50(1):29-33.

4. Wiseman JE, Mossanen M, Bath MT, Yeh M. An algorithm informed by parathyroid hormone level reduces hypocalcemic complication of thyroidectomy. World J Surg 2010;34:532-537.

5. Güllüoğlu BM, Manukyan MN, Cingi A, Yeğen C, et al. Early prediction of normocalcemia after thyroid surgery. World J Surg 2005;29:1288-1293.

6. C hia SH, Weisman RA, Tieu D, Kelly C, et al. Prospective study of perioperative factors predicting hypocalcemia after thyroid and parathyroid surgery. Arch Otolaryngol Head Neck Surg 2006;132:41-45.

7. C ampillo-Soto A, Lirón-Ruiz R, Martín-Lorenzo JG, Flores-Pastor B. Deconstruyendo la determinación de paratirina sérica como predictor de hipocalcemias postiroidectomía total. Cir Esp 2009;86(6):390-393.

8. Kara M, Tellioglu G, Krand O, Fersahoglu T, et al. Predictors of hypocalcemia occurring after a total/near total thyroidectomy. Surg Today 2009;39:752-757.

9. Dedivitis RA, Pfuetzenreiter EG Jr, Nardi CE, Barbara EC. Prospective study of clinical and laboratorial hypocalcemia after thyroid surgery. Braz J Otorhinolaryngol 2010;76:71-77.

10. Irkorucu O, Tascilar O, Cakmak GK, Emre AU, et al. Inadvertent parathyroidectomy and temporary hipocalcemia: an adverse natural outcome or a true complication during thyroidectomy? Endocr Regul 2007;41:143-148.