TY - JOUR
T1 - Intraoperative parathormone measurements and postoperative hypocalcemia
AU - Stepansky, Albert
AU - Gold-Deutch, Ruth
AU - Poluksht, Natan
AU - Hagag, Philippe
AU - Benbassat, Carlos
AU - Mor, Anat
AU - Aharoni, Dorit
AU - Wassermann, Ilan
AU - Halpern, Zvi
AU - Halevy, Ariel
PY - 2010/4
Y1 - 2010/4
N2 - Background: Hypocalcemia following thyroid and parathyroid surgery is a well-recognized potential complication. Objectives: To determine the utility of intraoperative quick parathormone assay in predicting severe hypocalcemia development following parathyroidectomy for a single-gland adenoma causing primary hyperparathyroidism. Methods: A retrospective cohort study was performed. IOQPTH values were measured at time 0 (T0) before incision, and 10 (T10) and 30 minutes (T30) following excision of the hyperfunctioning gland. Percent decrease in IO-QPTH at 10 minutes (T10), maximum percent decrease of IO-QPTH value, and lowest actual IO-QPTH value obtained at surgery were used to determine any correlation with the development of postoperative hypocalcemia requiring treatment. Results: Percent decrease in IO-QPTH at 10 minutes, maximum percent decrease in IO-QPTH and lowest IO-QPTH value did not correlate with the lowest postoperative calcium levels measured 18 hours after surgery (r = 0.017, P = 0.860; r = 0.018, P = 0.850; and r = 0.002, P = 0.985 respectively). For the purposes of our analysis, patients were subdivided into three groups. Group 1 comprised 68 patients with normal calcium levels (serum Ca 8.6-10.3 mg/dl), group 2 had 28 patients with hypocalcemia (8.1-8.6 mg/dl), and group 3 included 12 patients with severe hypocalcemia (calcium level ≤ 8.0 mg/dl) requiring calcium supplementation due to symptoms of hypocalcemia. There was no difference between the three groups in the lowest IO-QPTH value (P = 0.378), percent decrease in IO-QPTH (P = 0.305) and maximum percent decrease in IO-QPTH (P = 0.142). Conclusions: IO-QPTH evaluation was not useful in predicting the group of patients susceptible to develop severe postoperative hypocalcemia.
AB - Background: Hypocalcemia following thyroid and parathyroid surgery is a well-recognized potential complication. Objectives: To determine the utility of intraoperative quick parathormone assay in predicting severe hypocalcemia development following parathyroidectomy for a single-gland adenoma causing primary hyperparathyroidism. Methods: A retrospective cohort study was performed. IOQPTH values were measured at time 0 (T0) before incision, and 10 (T10) and 30 minutes (T30) following excision of the hyperfunctioning gland. Percent decrease in IO-QPTH at 10 minutes (T10), maximum percent decrease of IO-QPTH value, and lowest actual IO-QPTH value obtained at surgery were used to determine any correlation with the development of postoperative hypocalcemia requiring treatment. Results: Percent decrease in IO-QPTH at 10 minutes, maximum percent decrease in IO-QPTH and lowest IO-QPTH value did not correlate with the lowest postoperative calcium levels measured 18 hours after surgery (r = 0.017, P = 0.860; r = 0.018, P = 0.850; and r = 0.002, P = 0.985 respectively). For the purposes of our analysis, patients were subdivided into three groups. Group 1 comprised 68 patients with normal calcium levels (serum Ca 8.6-10.3 mg/dl), group 2 had 28 patients with hypocalcemia (8.1-8.6 mg/dl), and group 3 included 12 patients with severe hypocalcemia (calcium level ≤ 8.0 mg/dl) requiring calcium supplementation due to symptoms of hypocalcemia. There was no difference between the three groups in the lowest IO-QPTH value (P = 0.378), percent decrease in IO-QPTH (P = 0.305) and maximum percent decrease in IO-QPTH (P = 0.142). Conclusions: IO-QPTH evaluation was not useful in predicting the group of patients susceptible to develop severe postoperative hypocalcemia.
KW - Hyperparathyroidism
KW - Hypocalcemia
KW - Parathormone
KW - Parathyroidectomy
KW - Quick PTH
UR - http://www.scopus.com/inward/record.url?scp=77951914972&partnerID=8YFLogxK
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AN - SCOPUS:77951914972
SN - 1565-1088
VL - 12
SP - 207
EP - 210
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 4
ER -