Parathyroid Hormone Levels Predict Posttotal Thyroidectomy Hypoparathyroidism Article

PMID: 25105405 Web of Science: 000341812500035

Cited authors

  • Rivere, Amy E.; Brooks, Ashton J.; Hayek, Genevieve A.; Wang, Heng; Corsetti, Ralph L.; Fuhrman, George M.

Abstract

  • We hypothesized that parathyroid hormone (PTH) determination would be the most effective strategy to identify posttotal thyroidectomy hypoparathyroidism (PTTHP) compared with other clinical and laboratory parameters. We retrospectively reviewed our recent experience with total thyroidectomy. We recorded demographics, malignancy, thyroid weight, parathyroid autotransplantation, hospital stay, use of postoperative calcium and hormonally active vitamin D3 (calcitriol), and postoperative serum calcium and PTH levels. Patients were divided into two groups depending on whether supplemental calcitriol was required to maintain eucalcemia and therefore reflecting the diagnosis of PTTHP. From October 2010 to June 2013, a total of 202 total thyroidectomies were performed. Twenty-four patients (12%) developed PTTHP and required calcitriol replacement. Logistic regression analysis revealed that only postoperative calcium levels (P = 0.02) and PTH levels (P < 0.0001) statistically significantly predicted PTTHP. Twenty-two of 29 patients with PTH 13 pg/mL or less had PTTHP. Only two of 173 patients with a PTH level greater than 13 pg/mL were diagnosed with PTTHP. We recommend using PTH levels after total thyroidectomy to determine which patients will have hypoparathyroidism requiring calcitriol therapy. An early determination of PTTHP allows for prompt management that can shorten hospital stay and improve outcomes.

Publication date

  • 2014

Published in

International Standard Serial Number (ISSN)

  • 0003-1348

Start page

  • 817

End page

  • 820

Volume

  • 80

Issue

  • 8