Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study
Objective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papi...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2020/7189857 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849411305052569600 |
|---|---|
| author | Kangnan Mo Jinbiao Shang Kejing Wang Jialei Gu Peng Wang Xilin Nie Wendong Wang |
| author_facet | Kangnan Mo Jinbiao Shang Kejing Wang Jialei Gu Peng Wang Xilin Nie Wendong Wang |
| author_sort | Kangnan Mo |
| collection | DOAJ |
| description | Objective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papillary thyroid carcinoma. Setting. Patients were recruited between January 2016 and June 2018. Subjects and Methods. Patients who underwent bilateral (n = 155, bilateral group) and ipsilateral CLND (n = 21) after total thyroidectomy were included. The preoperative and postoperative parathyroid hormone (PTH) and calcium levels were detected. The risk factors for transient hypocalcemia were identified using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results. Fifty-one (28.98%) patients developed transient hypocalcemia, and 2 patients (1.14%) developed permanent hypoparathyroidism. There was no difference in the gender ratio or the morbidity of hypocalcemia between the patients who underwent bilateral and ipsilateral CLND. On postoperative day 1, PTH decrease was a risk factor for transient hypocalcemia in the whole cohort (β = 0.043, OR = 1.044, 95% CI 1.023–1.065, p<0.001), bilateral group (β = 0.042, OR = 1.043, 95% CI 1.022–1.064, p<0.001), and female patients (β = 0.049, OR = 1.050, 95% CI 1.026–1.075, p<0.001). Tumor diameter was a risk factor for transient hypocalcemia in female patients (β = 0.499, OR = 1.647, 95% CI 1.003–2.704, p=0.049). The ROC curve analysis illustrated that 65.58%, 71.00%, and 71.00% PTH level reduction had high accuracy in predicting transient hypocalcemia in the whole cohort, bilateral group, and female patients, respectively (AUC = 0.986, 0.987, and 0.987). Conclusion. Asymptomatic female patients with bilateral CLND and a 71.00% PTH level reduction were at a high risk of transient hypocalcemia. |
| format | Article |
| id | doaj-art-66ff9cc39f67404183e7dbec756b212d |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-66ff9cc39f67404183e7dbec756b212d2025-08-20T03:34:48ZengWileyInternational Journal of Endocrinology1687-83371687-83452020-01-01202010.1155/2020/71898577189857Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective StudyKangnan Mo0Jinbiao Shang1Kejing Wang2Jialei Gu3Peng Wang4Xilin Nie5Wendong Wang6Department of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 1 Banshan Road (East), Gongshu, Hangzhou 310022, ChinaDepartment of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 1 Banshan Road (East), Gongshu, Hangzhou 310022, ChinaDepartment of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 1 Banshan Road (East), Gongshu, Hangzhou 310022, ChinaDepartment of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 1 Banshan Road (East), Gongshu, Hangzhou 310022, ChinaDepartment of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 1 Banshan Road (East), Gongshu, Hangzhou 310022, ChinaDepartment of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 1 Banshan Road (East), Gongshu, Hangzhou 310022, ChinaDepartment of Head and Neck Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), No. 1 Banshan Road (East), Gongshu, Hangzhou 310022, ChinaObjective. We performed this study to investigate the risk factors for postoperative hypocalcemia after total thyroidectomy with central lymph node dissection (CLND). Study Design. This was a single-center prospective study based on 176 consecutive patients who underwent total thyroidectomy for papillary thyroid carcinoma. Setting. Patients were recruited between January 2016 and June 2018. Subjects and Methods. Patients who underwent bilateral (n = 155, bilateral group) and ipsilateral CLND (n = 21) after total thyroidectomy were included. The preoperative and postoperative parathyroid hormone (PTH) and calcium levels were detected. The risk factors for transient hypocalcemia were identified using logistic regression analysis and receiver operating characteristic (ROC) curve analysis. Results. Fifty-one (28.98%) patients developed transient hypocalcemia, and 2 patients (1.14%) developed permanent hypoparathyroidism. There was no difference in the gender ratio or the morbidity of hypocalcemia between the patients who underwent bilateral and ipsilateral CLND. On postoperative day 1, PTH decrease was a risk factor for transient hypocalcemia in the whole cohort (β = 0.043, OR = 1.044, 95% CI 1.023–1.065, p<0.001), bilateral group (β = 0.042, OR = 1.043, 95% CI 1.022–1.064, p<0.001), and female patients (β = 0.049, OR = 1.050, 95% CI 1.026–1.075, p<0.001). Tumor diameter was a risk factor for transient hypocalcemia in female patients (β = 0.499, OR = 1.647, 95% CI 1.003–2.704, p=0.049). The ROC curve analysis illustrated that 65.58%, 71.00%, and 71.00% PTH level reduction had high accuracy in predicting transient hypocalcemia in the whole cohort, bilateral group, and female patients, respectively (AUC = 0.986, 0.987, and 0.987). Conclusion. Asymptomatic female patients with bilateral CLND and a 71.00% PTH level reduction were at a high risk of transient hypocalcemia.http://dx.doi.org/10.1155/2020/7189857 |
| spellingShingle | Kangnan Mo Jinbiao Shang Kejing Wang Jialei Gu Peng Wang Xilin Nie Wendong Wang Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study International Journal of Endocrinology |
| title | Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study |
| title_full | Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study |
| title_fullStr | Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study |
| title_full_unstemmed | Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study |
| title_short | Parathyroid Hormone Reduction Predicts Transient Hypocalcemia after Total Thyroidectomy: A Single-Center Prospective Study |
| title_sort | parathyroid hormone reduction predicts transient hypocalcemia after total thyroidectomy a single center prospective study |
| url | http://dx.doi.org/10.1155/2020/7189857 |
| work_keys_str_mv | AT kangnanmo parathyroidhormonereductionpredictstransienthypocalcemiaaftertotalthyroidectomyasinglecenterprospectivestudy AT jinbiaoshang parathyroidhormonereductionpredictstransienthypocalcemiaaftertotalthyroidectomyasinglecenterprospectivestudy AT kejingwang parathyroidhormonereductionpredictstransienthypocalcemiaaftertotalthyroidectomyasinglecenterprospectivestudy AT jialeigu parathyroidhormonereductionpredictstransienthypocalcemiaaftertotalthyroidectomyasinglecenterprospectivestudy AT pengwang parathyroidhormonereductionpredictstransienthypocalcemiaaftertotalthyroidectomyasinglecenterprospectivestudy AT xilinnie parathyroidhormonereductionpredictstransienthypocalcemiaaftertotalthyroidectomyasinglecenterprospectivestudy AT wendongwang parathyroidhormonereductionpredictstransienthypocalcemiaaftertotalthyroidectomyasinglecenterprospectivestudy |