Parathyroid Hormone Assay as a Predictor for Post Operative Hypocalcemia in Patients Undergoing Total Thyroidectomy

Document Type : Original Article

Authors

1 Department of Surgical Oncology, Kauvery Hospitals, Tennur, Trichy, Tamil Nadu, India.

2 Department of General Surgery, KMC Specialty, Trichy, Tamil Nadu, India.

Abstract

Background: Serum parathyroid hormone assay in the immediate post operative period and at 24 hours can be used as a very reliable predictor for identifying patient at risk of developing Clinically symptomatic hypocalcemia. This study was aimed to ascertain if post operative Parathyroid assay can be used to predict patients at risk of developing clinically symptomatic hypocalcemia and thereby selecting patients for early discharge and patients who will benefit from prophylactic calcium supplements.
Patients and Methods: All patients who underwent Total thyroidectomy with or without neck dissection from October 2021 to June 2022 were included in the study. Samples for serum PTH within 1 hour and 24 hours post-thyroidectomy along with Serum calcium on post-operative days 1,3 and 5 were collected for analysis.
Results: Total number of patients in the study group was 25. Only 5% (3/22) had signs of hypocalcemia. Out of 25 patients 9 were operated for carcinoma of thyroid. 2 patients underwent total thyroidectomy with CCND and ipsilateral neck dissection. Female: Male was 3:1. The median age for female and male was 48 and 49 respectively.  There was no significant difference in the PTH value measured within 1hr of surgery vs 24hrs post-surgery (p=0.329). The median PTH value for the patient who did not require calcium supplements was 19(8.91-68.3). The median PTH who required calcium supplement (oral/intravenous supplement) was 5.25(3.3-8.39). The mean post-operative stay was 2.25±0.46, and 4.07±1.20 for those patients who had normal and abnormal PTH value.
Conclusion: Hypocalcemia following thyroidectomy is multifaceted in its development. As an outcome, we have found that taking a 1 hour and 24-hour PTH test measurement is a reliable and early indicator of hypocalcemia.

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