Register for Hypocalcemia is complication for women undergoing thyroidectomy
Thyroid SurgeryAugust 21, 2004
2004 AUG 21 - (NewsRx.com & NewsRx.net) -- Female patients with low thyroid stimulating hormone levels who are undergoing parathyroid-sparing total thyroidectomy are at risk for postoperative hypocalcemia and should receive calcium prophylaxis, recommend surgeons.
"Hypocalcemia following parathyroid-sparing total thyroidectomy is frequent and can prolong hospital stay. We undertook this study to identify preoperative predictors of postoperative hypocalcemia useful in the postoperative management of these patients," said A. Bove and colleagues, University G D'Annunzio.
The surgeons "examined patients undergoing total thyroidectomy for benign disease with preservation of at least three parathyroids from January 2000 to January 2001."
"Low serum calcium was considered below 8.0 mg/dL. Age, gender, preoperative serum calcium, thyroid stimulating hormone (TSH), T3, T4, albumin, cholesterol, and tryglicerides were compared in patients with normal and low serum calcium level on the second postoperative day and on discharge day by using X2 test and a model of logistic regression. Data were reported using their frequency distribution among the two groups of patients," the team said.
Study subjects were 60 females and 20 males undergoing parathyroid-sparing total thyroidectomy.
Bove and associates reported that on the second day after surgery, "hypocalcemia occurred in 42 patients, and 56% were symptomatic. Only female gender (88% F vs 12% M) (p<.05) and TSH <0.27 mUl/mL (38% vs 18%) (p<.05) predicted hypocalcemia."
"Similarly," they said, "female gender predicted hypocalcemia in a logistic regression analysis (p<.05)."
Of the 80 patients, 22 had low serum calcium levels on the day they were discharged; 50% of these were symptomatic. "At this time, only TSH value < 0.27 mlU/mL significantly predicted hypocalcemia (48% vs 17%) (p 0.05). This was confirmed in a logistic regression analysis (p<.05). All but one patient (98%) eventually returned to normal serum calcium levels," the surgeons reported.
They concluded, "Despite preservation of parathyroids, transient symptomatic hypocalcemia is common after total thyroidectomy. Female gender and low TSH serum level predicted hypocalcemia. Therefore, female patients undergoing total thyroidectomy with preoperative low TSH levels should receive calcium prophylaxis to decrease morbidity, shorten hospital stay, and decrease costs."
Bove and coauthors published their study in American Surgeon (Should female patients undergoing parathyroid-sparing total thyroidectomy receive routine prophylaxis for transient hypocalcemia? Am Surg, 2004;70(6):533-536).
For additional information, contact A. Bove, University G D'Annunzio, Department of Surgery, Palazzina SeBi , Via dei Vestini, I-66013 Chieti, Scalo, Italy.
Publisher contact information for the journal American Surgeon is: Southeastern Surgical Congress, 141 West Wieuca Rd., Ste. B100, Atlanta, GA 30342 USA.
The information in this article comes under the major subject areas of Endocrinology, Thyroidectomy, and Postsurgical Complications. This article was prepared by Obesity, Fitness & Wellness Week editors from staff and other reports. Copyright 2004, Obesity, Fitness & Wellness Week via NewsRx.com & NewsRx.net.
©Copyright 2004, Immunotherapy Weekly via NewsRx.com & NewsRx.net
