A nomogram to predict the likelihood of permanent hypoparathyroidism after total thyroidectomy based on delayed serum calcium and iPTH measurements

2017
journal article
article
26
dc.abstract.enBackground: Retrospective studies have shown that delayed high-normal serum calcium and detectable iPTH are independent variables positively influencing outcome of prolonged parathyroid failure after total thyroidectomy (TT). The aim of the present study was to examine prospectively the ability of these two variables to predict permanent hypoparathyroidism in patients under replacement therapy for postoperative hypocalcemia. Methods: Prospective observational multicenter study of patients undergoing TT followed by postoperative parathyroid failure (serum calcium <8 mg/dL within 24 h and PTH <15 pg/mL 4 h after surgery). Serum calcium, vitamin D and iPTH were determined before thyroidectomy, 24 h after surgery, at 1 month and then periodically until recovery of the parathyroid function or permanent hypoparathyroidism was diagnosed after at least 1 year follow-up. Results: Some 145 patients with postoperative hypocalcemia were investigated [s-Ca24h 7.5 (0.5) mg/dL]. Hypocalcemia recovered within 30 days in 91 (63%) patients and 54 (37%) developed protracted hypoparathyroidism {iPTH 5.8 [4] pg/mL at 1 month}, of whom 32 recovered within 1 year and 22 developed permanent hypoparathyroidism. Protracted hypoparathyroidism was related to few parathyroid glands remaining in situ (PGRIS). Serum calcium concentration (mg/dL) at 1 postoperative month correlated positively with the rate of recovery (percent) from protracted hypoparathyroidism: <8.5 (20%); 8.5–9 (29%); 9.1–9.5 (70%); 9.6–10 (89%); >10 (83%) (P=0.013). Serum iPTH at 1 month was also higher (7.3 vs. 3.7 pg/mL; P=0.002) in recovered protracted hypoparathyroidism. The combination of both variables predicts the likelihood of recovery of the parathyroid function with >90% accuracy. Conclusions: High-normal serum calcium and low but detectable iPTH concentrations at 1 month after TT were associated with better outcome of protracted hypoparathyroidism. A nomogram combining both variables may guide medical treatment and monitoring of post-thyroidectomy prolonged hypoparathyroidism.pl
dc.affiliationWydział Lekarski : Klinika Chirurgii Endokrynologicznejpl
dc.cm.date2020-01-07
dc.cm.id87168
dc.contributor.authorSitges-Serra, Antoniopl
dc.contributor.authorGomez, Joaquinpl
dc.contributor.authorBarczyński, Marcin - 128676 pl
dc.contributor.authorLorente-Poch, Leyrepl
dc.contributor.authorIacobone, Mauriziopl
dc.contributor.authorSancho, Juanpl
dc.date.accessioned2020-01-17T09:20:30Z
dc.date.available2020-01-17T09:20:30Z
dc.date.issued2017pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.numbersuppl. 1pl
dc.description.physicalS11-S19pl
dc.description.points15pl
dc.description.publication1,08pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume6pl
dc.identifier.doi10.21037/gs.2017.10.04pl
dc.identifier.eissn2227-8575pl
dc.identifier.issn2227-684Xpl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/142402
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-ND
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl*
dc.scopuswos.indexingtakpl
dc.share.typeotwarte czasopismo
dc.subject.enthyroidectomypl
dc.subject.enhypoparathyroidismpl
dc.subject.enmanagementpl
dc.subject.enpredictive variablespl
dc.subject.ennomogrampl
dc.subtypeArticlepl
dc.titleA nomogram to predict the likelihood of permanent hypoparathyroidism after total thyroidectomy based on delayed serum calcium and iPTH measurementspl
dc.title.journalGland Surgerypl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
Background: Retrospective studies have shown that delayed high-normal serum calcium and detectable iPTH are independent variables positively influencing outcome of prolonged parathyroid failure after total thyroidectomy (TT). The aim of the present study was to examine prospectively the ability of these two variables to predict permanent hypoparathyroidism in patients under replacement therapy for postoperative hypocalcemia. Methods: Prospective observational multicenter study of patients undergoing TT followed by postoperative parathyroid failure (serum calcium <8 mg/dL within 24 h and PTH <15 pg/mL 4 h after surgery). Serum calcium, vitamin D and iPTH were determined before thyroidectomy, 24 h after surgery, at 1 month and then periodically until recovery of the parathyroid function or permanent hypoparathyroidism was diagnosed after at least 1 year follow-up. Results: Some 145 patients with postoperative hypocalcemia were investigated [s-Ca24h 7.5 (0.5) mg/dL]. Hypocalcemia recovered within 30 days in 91 (63%) patients and 54 (37%) developed protracted hypoparathyroidism {iPTH 5.8 [4] pg/mL at 1 month}, of whom 32 recovered within 1 year and 22 developed permanent hypoparathyroidism. Protracted hypoparathyroidism was related to few parathyroid glands remaining in situ (PGRIS). Serum calcium concentration (mg/dL) at 1 postoperative month correlated positively with the rate of recovery (percent) from protracted hypoparathyroidism: <8.5 (20%); 8.5–9 (29%); 9.1–9.5 (70%); 9.6–10 (89%); >10 (83%) (P=0.013). Serum iPTH at 1 month was also higher (7.3 vs. 3.7 pg/mL; P=0.002) in recovered protracted hypoparathyroidism. The combination of both variables predicts the likelihood of recovery of the parathyroid function with >90% accuracy. Conclusions: High-normal serum calcium and low but detectable iPTH concentrations at 1 month after TT were associated with better outcome of protracted hypoparathyroidism. A nomogram combining both variables may guide medical treatment and monitoring of post-thyroidectomy prolonged hypoparathyroidism.
dc.affiliationpl
Wydział Lekarski : Klinika Chirurgii Endokrynologicznej
dc.cm.date
2020-01-07
dc.cm.id
87168
dc.contributor.authorpl
Sitges-Serra, Antonio
dc.contributor.authorpl
Gomez, Joaquin
dc.contributor.authorpl
Barczyński, Marcin - 128676
dc.contributor.authorpl
Lorente-Poch, Leyre
dc.contributor.authorpl
Iacobone, Maurizio
dc.contributor.authorpl
Sancho, Juan
dc.date.accessioned
2020-01-17T09:20:30Z
dc.date.available
2020-01-17T09:20:30Z
dc.date.issuedpl
2017
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
suppl. 1
dc.description.physicalpl
S11-S19
dc.description.pointspl
15
dc.description.publicationpl
1,08
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
6
dc.identifier.doipl
10.21037/gs.2017.10.04
dc.identifier.eissnpl
2227-8575
dc.identifier.issnpl
2227-684X
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/142402
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Bez utworów zależnych 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-ND
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-nd/4.0/legalcode.pl
dc.scopuswos.indexingpl
tak
dc.share.type
otwarte czasopismo
dc.subject.enpl
thyroidectomy
dc.subject.enpl
hypoparathyroidism
dc.subject.enpl
management
dc.subject.enpl
predictive variables
dc.subject.enpl
nomogram
dc.subtypepl
Article
dc.titlepl
A nomogram to predict the likelihood of permanent hypoparathyroidism after total thyroidectomy based on delayed serum calcium and iPTH measurements
dc.title.journalpl
Gland Surgery
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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