Postoperative PTH Measurement Is Not a Reliable Predictor for Hypocalcemia After Total Thyroidectomy in Vitamin D Deficiency: Prospective Study of 203 Cases

• Published in: World journal of surgery 2014-03, Vol.38 (3), p.564-567
• Main Authors: Pradeep, P. V., Ramalingam, K.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Biomarkers - blood; Cardiac Surgery; Deficient Patient; Female; General Surgery; Goiter; Goiter - complications; Goiter - surgery; Humans; Hypocalcemia - blood; Hypocalcemia - diagnosis; Hypocalcemia - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Parathyroid Hormone - blood; Postoperative Care; Postoperative Complications - blood; Postoperative Complications - diagnosis; Postoperative Period; Prospective Studies; Secondary Hyperparathyroidism; Serum Vitamin; Surgery; Thoracic Surgery; Thyroidectomy; Total Thyroidectomy; Vascular Surgery; Vitamin D Deficiency - complications
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-013-2350-9

Background Several factors have been used to predict post total thyroidectomy (TT) hypocalcemia. Serum intact PTH (PTH) levels 20 ng/mL) versus those who were vitamin D deficient (group B) were compared. Comparison was also performed between patients belonging to group A and group B who developed hypocalcemia. Appropriate statistical tests were applied. Results A total of 203 patients (19 males, 184 females) underwent TT; 58.6 % ( n = 119) belonged to group A and 41.4 % ( n = 84) to group B. Their mean age was 36.81 ± 12.9 years, and the mean duration of goiter was 45.35 ± 54.6 months. Hypocalcemia occurred in 41 patients (20.2 %). Among them 15 belonged to group A and 26 to group B ( p = 0.002). The mean PTH in patients who developed hypocalcemia was 12.75 ± 8.91 versus 22.58 ± 15.38 in those who did not develop hypocalcemia ( p = 0.00). Furthermore it was seen that the mean PTH in vitamin D sufficient hypocalcemic patients ( n = 15) was 7.12 ± 1.79 and that in vitamin D deficient hypocalcemic patients ( n = 26) was 16 ± 9.77 ( p = 0.001) Conclusions Our findings suggest that the fall in PTH after TT in vitamin D deficient patients is unreliable in predicting hypocalcemia and should not be relied on to plan early postoperative discharge.