Investigating the Risk Factors of Hypoparathyroidism after Total Thyroidectomy

Introduction: The aim of this study was to determine the outcome of low PTH after surgery and to monitor parathyroid recovery times in patients who underwent total thyroidectomy. Material and Methods: A commercially available PTH (iPTH) test was used to monitor iPTH levels on days ۱ and ۴. PTH levels were negative. It is determined by the same blood test as the sCa level. To exclude vitamin D deficiency, we first measured ۲۵-hydroxyvitamin D and ۱,۲۵-dihydroxyvitamin D levels in all patients Postoperative hypoparathyroidism was defined as postoperative albumin-adjusted sCa levels below ۱.۹ mmol/L (Convert to mg/dL, divide) with ۰.۲۵ (range of use, ۲.۱۰-۲.۶۰ mmol/L) symptoms of hypocalcemia (response to neuromuscular stress including paresthesias, muscle spasms, tetany or seizures) or sCa levels lower than results (۱.۹-۲.۱ mmol/L) with neuromuscular symptoms during the first ۴ days after surgery. Results: In a multivariate logistic regression model, we found that patients who received an autograft of parathyroid tissue during surgery were more likely to have low PTH immediately after surgery (OR = ۲.۶; ۹۵% CI, ۱.۸-۳.۸). Additionally, patients with parathyroid tissue who showed negative parathyroid tissue removal on the final pathology report were more likely to have postoperative PTH <۱۰ pg/mL (OR = ۲.۲; ۹۵% CI, ۱.۵ -۳.۳). Parathyroid tissue was the only risk factor for permanent hypoparathyroidism in the pathology report (OR = ۳.۶, ۹۵% CI, ۱.۱–۱۱.۵). Conclusion: This study suggests that drug therapy should be considered in addition to PTH measurement, as ۵۰% of patients with persistent hypoparathyroidism have elevated PTH levels to ≥۱۰ pg/mL, but still want more help to avoid hypoparathyroidism. Symptoms of calcemia. In addition, ۱۲ months may be the most appropriate time to define persistent hypoparathyroidism, as ۵% of patients with low PTH resolve ۶-۱۲ months after treatment.

کلیدواژه ها:

risk factor ، hypoparathyroidism ، thyroidectomy ، Predictors