MEDICIÓN DE NIVELES DE PARATHORMONA COMO PREDICTOR DE HIPOCALCEMIA SINTOMÁTICA EN EL POST-OPERATORIO PRECOZ DE TIROIDECTOMÍA TOTAL

Autor:	Matías Lavín G, Gerardo Mordojovich R, Nicolás Ávalos J
Rok vydání:	2015
Předmět:	Total thyroidectomy Parathormona medicine.medical_specialty cirugía tiroidea business.industry hipocalcemia medicine.disease Gastroenterology Surgery Dissection Internal medicine Relative risk Epidemiology medicine Hypocalcaemia Statistical analysis Complication business Thyroid cancer
Zdroj:	Revista chilena de cirugía v.67 n.2 2015 SciELO Chile CONICYT Chile instacron:CONICYT
ISSN:	0718-4026
DOI:	10.4067/s0718-40262015000200006
Popis:	Parathormone levels measurement as predictor of symptomatic hypocalcemia after total thyroidectomy introduction: The most frequent complication after total thyroidectomy is hypocalcemia. It is difficult to predict it. The objective of this paper is determinate if measurement of parathormone 6 hours after total thyroidectomy can predict symptomatic hypocalcemia, and determinate associated factors in the develop- ment of this complication. Material and Method: Prospective case series. Patients that underwent total thyroidectomy between 2006 and 2008 in our Hospital. We registered epidemiological data, related surgery factors and measurement of parathormone 6 hours after surgery. Hypocalcemia symptoms were registered. We used statistical analysis considering significant p < 0.05. results: We included 82 patients. Median age was 53.2 years. 79.3% were female. The average of parathormone 6 hours after surgery was 28.7 pg/dL. Sensibility was 100%, specificity 79.4%, positive predictive value 59.4%, negative predictive value 100% and accuracy 84.1% to predict symptomatic hypocalcaemia. A statistical association among levels under the normal base line of parathormone and symptomatic hypocalcemia was detected (p < 0.0001). Relative risk was 4.84. Univariated analysis showed association between hypocalcemia and pre-operative thyroid cancer diagnosis (p = 0.01), cervical dissection (p = 0.03) and level of parathormone (p = 0.002). Multivariated analysis showed that only the level of parathormone associates with hypocalcemia (p = 0.002). conclusion: The measurement of parathormone allows identifying which patients are at risk of presenting symptomatic hypocalcemia after total thyroidectomy.
Databáze:	OpenAIRE
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