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Early prediction of hypocalcemia following thyroid surgery. A prospective randomized clinical trial

  • Controlled Clinical Trials
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Abstract

Purpose

The aim of this randomized-controlled trial was to validate the results of a previous prospective single-cohort observational study conducted in the same surgical unit regarding the use of concomitant intact parathyroid hormone (iPTH) and serum calcium measurement in predicting hypocalcemia after total thyroidectomy.

Methods

From January 2014 to January 2015, 150 patients underwent total thyroidectomy in our department and were randomized into two groups. The experimental group was submitted to iPTH assay 6 h after surgery while the control group was submitted to a daily assay of serum calcium and phosphorus. Sensitivity and specificity of different serum measurements have been calculated using the receiver-operator characteristics (ROC) curve.

Results

The prevalence of hypocalcemia was 14.25% in both groups. The assay of iPTH 6 h after surgery combined with the serum calcium assay 24 h after surgery yielded the highest diagnostic accuracy in predicting hypocalcemia using ROC curves, with 100% sensitivity and 100% specificity.

Conclusions

According to our previous study, the combined measurement of iPTH 6 h after surgery and of serum calcium 24 h after surgery are highly predictive of early postoperative hypocalcemia. These results are important in selecting the patients eligible for early discharge and those who need calcium and vitamin D supplementation.

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Authors and Affiliations

  1. Department of Surgical Science, Azienda Ospedaliero-Universitaria, Presidio Policlinico di Monserrato, University of Cagliari, Blocco G, SS 554 km 4,500, 09042, Monserrato, CA, Italy

    Alessandra Saba, Mauro Podda, Antonio Messina Campanella & Adolfo Pisanu

Authors
  1. Alessandra Saba
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  2. Mauro Podda
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  3. Antonio Messina Campanella
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  4. Adolfo Pisanu
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Contributions

Saba A was principally involved in the study design, acquisition, interpretation, and analysis of data; drafting and critically revising the article for important intellectual content as well as in the final approval of the version are to be published. Podda M and Messina Campanella A were involved in the acquisition, interpretation, and analysis of data; drafting and critically revising the article for important intellectual content and in the final approval of the version are to be published. Pisanu A was involved in the study design, acquisition, interpretation, and analysis of data; drafting and critically revising the article for important intellectual content and in the final approval of the version are to be published.

Corresponding author

Correspondence to Alessandra Saba.

Ethics declarations

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent was obtained from all individual participants included in the study.

Disclosures

The authors declare that they have no conflict of interest.

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Saba, A., Podda, M., Messina Campanella, A. et al. Early prediction of hypocalcemia following thyroid surgery. A prospective randomized clinical trial. Langenbecks Arch Surg 402, 1119–1125 (2017). https://doi.org/10.1007/s00423-017-1586-5

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  • DOI: https://doi.org/10.1007/s00423-017-1586-5

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