ECE2017 Guided Posters Thyroid 3 (8 abstracts)
Will it be useful to measure PTH at 4 hours post thyroidectomy to decide for calcium replacement? 1st result of a prospective study
Sílvia Silva 1 , Ana Rafael 1 , Ricardo Marques 1 , Luisa Moniz 1 , Carlos Costa 1 , Ricardo Capitão 2 , Catarina Saraiva 2 , Clotilde Limbert 2 , Luis Fernandes 1 & Rogério Matias 1
1Surgery, Egas Moniz Hospital, Lisboa, Portugal; 2Endocrinology, Egas Moniz Hospital, Lisboa, Portugal.
Introduction: Calcium replacement after Thyroid surgery has been changing along times. The aim for this replacement is to avoid hypocalcaemia effects after thyroid surgery but not all the patients seem to need it. Parathyroid hormone (PTH) has a short half-life after its release into the bloodstream, making it a good marker of calcium metabolism in short time after surgery.
Method: Prospective study of Endocrine Surgery Multidisciplinary group of one Centre between March and December of 2016. Calcium replacement was done according to a protocol defined by multidisciplinary group after PTH measurement. PTH values were considered normal above 15 pg/ml. Data were analyzed using SPSS.
Results: 96 patients underwent total thyroidectomy vs totalization of thyroidectomy. 5 were excluded since they were admitted at ICU and protocol was not implemented. PTH was measured 4 hours after surgery.
From the 91 patients, 74 had normal PTH levels. The remaining patients (17) started calcium replacement according to established protocol and showed no symptoms of hypocalcaemia.
Considering group with normal PTH, at day one after surgery, 41 had normal calcium levels (P 0,01 on correlation analysis) and 33 had low levels. This last group started the protocol of calcium replacement and at day two after surgery were observed higher calcium levels (P 0,001 at linear analysis) and didn’t refer hypocalcaemia symptoms.
Our Sample has a significance of 0.05 in the non-parametric, Q-square and Kolmogorov-Smirnov test.
Conclusion: Measuring PTH 4 hours after surgery is helpful to decide which patients should start calcium replacement, using PTH value cut-off of 15 pg/ml.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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