Evaluation of Serum Calcium Levels in Predicting Hypoparathyroidism after Total/Near-Total Thyroidectomy or Parathyroidectomy

Bentrem, David J.; Rademaker, Alfred; Angelos, Peter
March 2001
American Surgeon;Mar2001, Vol. 67 Issue 3, p249
Academic Journal
Hospital stays for thyroid and parathyroid surgery have decreased significantly with selected patients staying under 8 hours. Strategies to recognize hypocalcemia postoperatively vary. We examined timed postoperative calcium levels to determine how long one needs to monitor patients for hypoparathyroidism. We analyzed 120 consecutive patients having total/near-total thyroidectomy and/or parathyroidectomy between April 1998 and October 1999. Total and ionized serum calcium levels were obtained at 8, 16, and 22 hours postoperatively. Strict criteria for significant hypoparathyroidism were defined as a symptomatic patient, a total calcium value of less than 7.2 mg/dL, or an ionized calcium value of less than 1.0 mmol/L. Eighteen patients (15%) met criteria for hypocalcemia. The 8-hour longed calcium level identified 40 per cent of those that needed supplementation. With the inclusion of the 16-hour ionized calcium value 94.5 per cent of patients who met criteria were identified. Of the 74 patients who had not previously received calcium at 22 hours after surgery only one patient with hypocalcemia was identified. Serial calcium values postoperatively add to the costs associated with an overnight hospital stay. In addition to clinical examination an ionized calcium level 16 hours postoperatively is sufficient to identify significant hypoparathyroidism in the majority of patients.


Related Articles

  • Course of Ionized Calcium After Thyroidectomy. de Andrade Sousa, Alexandre; Salles, José Maria Porcaro; Soares, João Macros Arantes; de Moraes, Gustavo Mayer; Carvalho, Jomar Rezende; Rocha, Paulo Roberto Savassi // World Journal of Surgery;May2010, Vol. 34 Issue 5, p987 

    The goal of the present study was to investigate the course of ionized calcium after thyroidectomy and to define a cut-off value that indicates symptoms of hypocalcemia. The sample included 333 patients undergoing thyroidectomy at the University Hospital of UFMG between September 2000 and...

  • LETTERS TO THE EDITOR. Herzon, Fred; Burge, Mark R. // JGIM: Journal of General Internal Medicine;Jun1988, Vol. 13 Issue 6, p428 

    Focuses on issues related to the media environment surrounding the clinical research on the risks of complication following thyroidectomy. Development of postoperative hypoparathyroidism; Increase in risk factors in patients with advanced cancer; Rate of persistent hypoparathyroidism after...

  • Postoperative Parathyroid Hormone Level as a Predictor of Post-thyroidectomy Hypocalcemia. Payne, Richard J.; Hier, Michael P.; Black, Martin J.; Tamilia, Michael; Young, Jonathan; MacNamara, Elizabeth // Journal of Otolaryngology;Nov/Dec2003, Vol. 32 Issue 6, p362 

    Objectives: To evaluate levels of parathyroid hormone following total thyroidectomy in order to ascertain its ability to predict postoperative hypocalcemia. To establish standardized criteria permitting the safe discharge of total thyroidectomy patients within 13 hours of surgery. Methods: This...

  • Tetany induced by frusemide in latent hypoparathyroidism.  // British Medical Journal (Clinical Research Edition);10/17/1987, Vol. 295 Issue 6604, p960 

    Focuses on the tetany induced by frusemide in latent hypoparathyroidism. Precipitation of tetany in a patient eighteen years after thyroidectomy; Reasons on permanent symptomatic hypoparathyroidism after thyroid surgery; Precipitating factors on patients with the longest reported latent period...

  • Algorithm for early discharge after total thyroidectomy using PTH to predict hypocalcemia: prospective study. Schlottmann, F.; Arbulú, A.; Sadava, E.; Mendez, P.; Pereyra, L.; Fernández Vila, J.; Mezzadri, N. // Langenbeck's Archives of Surgery;Oct2015, Vol. 400 Issue 7, p831 

    Purpose: Hypocalcemia is the most common complication after total thyroidectomy. The aim of this study was to determine whether postoperative parathyroid hormone (PTH) levels predict hypocalcemia in order to design an algorithm for early discharge. Methods: We present a prospective study...

  • Normal Parathyroid Hormone Levels Do Not Exclude Permanent Hypoparathyroidism After Thyroidectomy. Regina Promberger; Johannes Ott; Friedrich Kober; Michael Karik; Michael Freissmuth; Michael Hermann // Thyroid;Feb2011, Vol. 21 Issue 2, p145 

    Background:Permanent hypoparathyroidism has become the most common and the most severe complication after thyroid surgery. In our experience, some patients suffer from permanent hypocalcemia and related symptoms despite normal parathyroid hormone (PTH) values after thyroid surgery. The aim of...

  • NPS creates registry to bolster its drug. Zanki, Tom // njbiz;8/12/2013, p2 

    The article reports that drugmaker NPS Pharmaceuticals Inc. has created a global registry for patients with hypoparathyroidism wherein enrolled patients will be followed for 10 years in the hopes of learning more about the unusual disorder which causes blood calcium levels to drop.

  • Recombinant parathyroid hormone shows promise for hypoparathyroidism.  // Endocrine Today;Dec2012, Vol. 10 Issue 12, p9 

    The article highlights the work done by Columbia University College of Physicians and Surgeons researchers where they discovered that serum calcium concentrations was maintained while supplemental calcium and vitamin D requirements were reduced in patients with hypoparathyroidism by a human...

  • Renal handling of calcium in hypoparathyroidism. Newman, G.H.; Wade, M.; Hosking, D.J. // British Medical Journal (Clinical Research Edition);9/17/1983, Vol. 287 Issue 6395, p781 

    Investigates the handling of urinary calcium in hypoparathyroidism. Role of Vitamin D metabolites in the maintenance of calcium and phosphate homeostasis; Administration of Vitamin D metabolites for the treatment of hypercalcemia; Methods in maintaining serum and urinary calcium levels in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics