Jae Won Chang1, Ki Wan Park1, Seung-Nam Jung1, Lihua Liu2, Sung Min Kim3, Bon Seok Koo4. 1. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Research Institute for Medical Science, Chungnam National University, 640 Daesa-Dong, Chung-Gu, Daejeon, 301-721, Republic of Korea. 2. Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea. 3. Department of Nuclear Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea. 4. Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Research Institute for Medical Science, Chungnam National University, 640 Daesa-Dong, Chung-Gu, Daejeon, 301-721, Republic of Korea. bskoo515@cnuh.co.kr.
Abstract
PURPOSE: We assessed the optimal time for intact parathyroid hormone (iPTH) measurement for early detection of post-total thyroidectomy (TT) hypocalcemia in patients with papillary thyroid carcinoma (PTC). METHODS: In this single-center prospective cohort study, 143 patients who underwent TT with central neck dissection with or without lateral neck dissection for PTC were included. Biochemical profiles including iPTH, corrected total calcium, and ionized calcium within 24 h after surgery were analyzed. RESULTS: The 4-h postoperative iPTH was the most reliable predictor of post-TT transient or permanent hypoparathyroidism (cutoff for hypocalcemia was 3.75 pg/mL, AUC = 0.885, P < 0.001, sensitivity 81.6%, specificity 86.0%; cutoff for permanent hypocalcemia was 2.48 pg/mL, AUC = 0.819, P < 0.001, sensitivity 100%, specificity 57.8% calculated using ROC curves). CONCLUSIONS: The 4-h postoperative iPTH can most accurately predict hypoparathyroidism after TT with central neck dissection to treat PTC and facilitate the early discharge of low-risk postoperative hypoparathyroidism patients and decrease unnecessary overnight observation and calcium supplementation.
PURPOSE: We assessed the optimal time for intact parathyroid hormone (iPTH) measurement for early detection of post-total thyroidectomy (TT) hypocalcemia in patients with papillary thyroid carcinoma (PTC). METHODS: In this single-center prospective cohort study, 143 patients who underwent TT with central neck dissection with or without lateral neck dissection for PTC were included. Biochemical profiles including iPTH, corrected total calcium, and ionized calcium within 24 h after surgery were analyzed. RESULTS: The 4-h postoperative iPTH was the most reliable predictor of post-TT transient or permanent hypoparathyroidism (cutoff for hypocalcemia was 3.75 pg/mL, AUC = 0.885, P < 0.001, sensitivity 81.6%, specificity 86.0%; cutoff for permanent hypocalcemia was 2.48 pg/mL, AUC = 0.819, P < 0.001, sensitivity 100%, specificity 57.8% calculated using ROC curves). CONCLUSIONS: The 4-h postoperative iPTH can most accurately predict hypoparathyroidism after TT with central neck dissection to treat PTC and facilitate the early discharge of low-risk postoperative hypoparathyroidismpatients and decrease unnecessary overnight observation and calcium supplementation.
Entities:
Keywords:
Intact parathyroid hormone; Optimal time point; Post-thyroidectomy hypocalcemia
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