Use of parathormone as a predictor of hypoparathyroidism after total thyroidectomy

Abstract

Background: Post-operative hypoparathyroidism is the most frequent complication after total thyroidectomy. It represents one of the main causes of prolonged hospital-stay and is associated with a significant increase in health costs. The identification of patients with higher risk of suffering this complication allows early treatment, reduces clinical complications and adequate the use of health resources. Throughout history, several predictors have been used to stratify patients at risk. In recent years the use of parathormone parathyroid hormone (PTH) has taken particular interest. Objective: To review the existing literature on the use of PTH as a predictor of hypocalcemia after thyroidectomy. Method: A medline search was performed. We reviewed the existing evidence on efficacy of PTH as a predictor of post-operative hypocalcemia, economic impact, optimal time for sampling and implementation mode. Conclusion: The use of PTH predicts with adequate sensitivity, specificity, negative and positive predictive value the risk for the patients to suffer post-operative hypocalcemia. Cut-off values and sampling number and time vary among authors; as a result, more data is needed to reach a conclusion about the standardization of use after a total thyroidectomy procedure. It use could be beneficial not only for patients but also for care providers as health cost might be diminished.