Comparative evaluation of preand postoperative predictors of hypocalcemia in patients with thyroid cancer

Abstract

The objectives of this study was to identify the incidence of hypocalcemia, depending on the surgery and to examine the main predictors of postoperative hypocalcemia in patients with adenocarcinoma of the thyroid for medical treatment.Materials and Methods. Data were collected prospectively from 2011 to 2014. We analyzed 98 patients after surgical treatment for thyroid cancer. All patients underwent thyroidectomy, some patients without prophylactic сentral neck dissection ( n = 41, group A), and the proportion of patients with suspected metastatic lymph nodes more сentral neck dissection was performed ( n = 57, group B). Depending on the calcium concentration postoperative patients in groups A and B were further divided into two subgroups. In one subgroup of postoperative calcium level in the serum was 2.0 mmol/l or less, and in subgroup 2 exceeded2.0 mmol/l. Also, patients were determined in pre- and postoperative levels of 25 (OH) D, parathyroid hormone in the serum.Reults. Using logistic regression analysis showed that factors predictive postoperative hypocalcemia are: preoperative 25 (OH) D - less than 15 ng/ml ( p <0.001), postoperative PTH level in the blood serum - below 10 pg/ml ( p = 0.01).Conclusions. In most cases, age, low preoperative level of 25 (OH) D serum levels and low postoperative PTH level in blood serum is largely associated with the development of postoperative hypocalcemia. Among the factors influencing the development of postoperative hypocalcemia major role in the evaluation group played the volume of surgical intervention - a worst case was a combination of thyroidectomy with сentral neck dissection.