ArticleThe Journal of surgical research2016
One-hour PTH after thyroidectomy predicts symptomatic hypocalcemia.
Article in The Journal of surgical research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Definition and diagnosis of postsurgical hypoparathyroidism after thyroid surgery: meta-analysis.BJS open · 2022Pooled it
- Pooled it
- Early prediction of hypocalcemia following thyroid surgery. A prospective randomized clinical trial.Langenbeck's archives of surgery · 2017Trial
- Independent Predictors of Symptomatic Hypocalcemia Following Thyroidectomy: Distinguishing Biochemical and Symptomatic Hypocalcemia.Journal of clinical medicine · 2026Article
- Early Postoperative PTH Determination as Predictor for Post-Thyroidectomy Hypocalcemia.International archives of otorhinolaryngology · 2026Article
- Intact Parathyroid Hormone Levels in Predicting Postoperative Hypocalcaemia After Total Thyroidectomy in South Indian Population: Cross Sectional Study.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2022Article
- Can preoperative 25-hydroxyvitamin D levels predict transient hypocalcemia after total thyroidectomy?Updates in surgery · 2022Article
- Predicting risk factors of postoperative hypocalcemia after total thyroidectomy: is safe discharge without supplementation possible? A large cohort study.Langenbeck's archives of surgery · 2021Article
- Risk Factors for Low Levels of Parathyroid Hormone after Surgery for Thyroid Cancer: A Single Center Study.Journal of clinical medicine · 2021Article
- The Effect of Parathyroid Gland Autotransplantation on Hypoparathyroidism After Thyroid Surgery for Papillary Thyroid Carcinoma.Cancer management and research · 2021Article
- Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study.International journal of endocrinology · 2020Article
- Considerations for Thyroidectomy as Treatment for Graves Disease.Clinical medicine insights. Endocrinology and diabetes · 2019Review
- Variation of Thyroidectomy-Specific Outcomes Among Hospitals and Their Association With Risk Adjustment and Hospital Performance.JAMA surgery · 2018Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundA major morbidity after total thyroidectomy is hypocalcemia. Although many clinical factors and laboratory studies have been correlated with both biochemical and symptomatic hypocalcemia, the ideal use and timing of these tests remain unclear. We hypothesize 1-h (PACU) parathyroid hormone (PTH) will identify patients at risk for symptomatic hypocalcemia.
methodsThis prospective study evaluated 196 patients undergoing total thyroidectomy. Serum calcium and PTH levels were measured 1 h after surgery and on postoperative day 1 (POD1). Performance of a central compartment lymph node dissection, parathyroid autotransplantation, indication for procedure, pathology, and presence of parathyroid tissue in the pathology specimen were recorded.
resultsOf 196 patients, nine (4.6%) developed symptomatic hypocalcemia. Thirty four (17.3%) had a 1-h PACU PTH ≤10 pg/dL, whereas 31 (15.8%) had a POD1 PTH of ≤10. Five (56%) of the nine symptomatic patients underwent central compartment lymph node dissection, four (44%) had parathyroid autotransplantation, and four (44%) had a PACU PTH ≤10. PACU and POD1 PTH levels were correlated (R(2) = 0.682). Multivariate regression identified central compartment dissection, autotransplantation, and PACU or POD1 PTH correlated with symptomatic hypocalcemia. PACU PTH, POD1 PTH, PACU Ca, malignant final pathology, and age ≤45 y correlated with biochemical hypocalcemia.
conclusionsA 1-h postoperative PACU PTH is equivalent to POD1 PTH in predicting the development of symptomatic hypocalcemia. Biochemical hypocalcemia was not predictive of symptoms in the immediate postoperative period. Lymph node dissection and parathyroid autotransplantation correlated with symptomatic hypocalcemia and improve the sensitivity of biochemical screening alone.
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