FIRST DAY SERUM CALCIUM AND PARATHYROID HORMONE LEVELS AS PREDICTIVE FACTORS FOR SAFE DISCHARGE AFTER THYROIDECTOMY.

Abstract

Context\nPermanent hypocalcemia is a rare but significant complication of thyroid surgery.\n\n\nObjective\nThe aim of this study was to identify predictive factors of hypocalcemia and hypoparathyroidism after thyroidectomy.\n\n\nDesign\nStudy included 134 total patients submitted to thyroidectomy from two endocrine units (January 2015 - August 2016).\n\n\nMethods\nWe measured total serum calcium (sCa) and intact PTH (iPTH) on postoperative day one and 1 month after surgery.\n\n\nResults\n118 patients were women with F/M ratio of 7.3/1 and a mean age of 51.8 years. 64 patients were included in group A (iPTH <12 pg/mL) and 70 patients in group B (iPTH >12 pg/mL). sCa and hypocalcemia symptoms were correlated with iPTH, measured 24 hours after surgery. The cut-off value was for sCa 8.05 mg/dL with a sensitivity of 85.29% and a specificity of 88.0% and for iPTH 11.2 pg/mL, with a sensitivity of 82.3% and a specificity of 71.0%. SCa (< 8.05 mg/dL) was a predictive factor with a 99 (IC95%:12.86-761.58) and iPTH (<11.2 pg/mL) with a 10.77 higher risk (CI95%: 3.83-30.30) to be associated with symptoms.\n\n\nConclusion\nSCa and iPTH represent good predictive factors of early and safe hospital discharge and can predict the risk of prolonged and permanent hypoparathyroidism.