Parathyroid hormone assay following total thyroidectomy for early prediction of post-operative hypocalcemia

Naveen Arnepalli; Chethan Kishanchand; Balaji Jayasankar

doi:10.18203/2349-2902.isj20180838

Authors

Naveen Arnepalli Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India
Chethan Kishanchand Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India
Balaji Jayasankar Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20180838

Keywords:

Hypocalcaemia, Parathyroid hormone assay, Total thyroidectomy

Abstract

Background: Detecting post-operative hypocalcaemia following total thyroidectomy using serum parathyroid hormone levels would help in an earlier and a definitive treatment plan in treating hypocalcaemia.

Methods: This was a prospective interventional study done in a tertiary care teaching hospital. This was mainly done to assess the post-operative hypocalcemia following total thyroidectomy using parathyroid hormone levels and to assess the correlation between the two. With a baseline levels recorded patients underwent a post-operative evaluation of parathyroid hormone 1 hour after total thyroidectomy and serum calcium levels on day 1, 2, 3 and 4 after surgery. The same was statically analyzed to find a correlation between parathyroid hormone levels and the degree of hypocalcemia and evaluated to see if parathyroid hormone was a reliable clinical indicator.

Results: A total of 43 patients were included in the study and the parathyroid hormone levels were assessed following surgery, the same was plotted statistically. Sensitivity of parathyroid hormone drop by 75% in predicting hypocalcaemia was 95%. 50% drop in parathyroid hormone levels was a sensitive predictor of hypocalcaemia. A PTH value of less than 15.1pg/ml was highly specific and sensitive indicator of hypocalcaemia.

Conclusions: Parathyroid hormone Assay following total thyroidectomy is reliable for early prediction of hypocalcaemia. Patients with a parathyroid hormone level <9pg/ml or with 75% drop in parathyroid hormone level are at a high risk for hypocalcaemia and would require calcium supplementation.

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