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Parathyroid score can predict the duration of required calcium supplementation after total thyroidectomy

 Bup-Woo Kim  ;  Soo Young Kim  ;  Yong Sang Lee  ;  Seok-Mo Kim  ;  Hang-Seok Chang  ;  Cheong Soo Park 
 PLOS ONE, Vol.12(3) : e0174088, 2017 
Journal Title
Issue Date
Adult ; Aged ; Calcium/administration & dosage ; Calcium/blood* ; Color ; Dietary Supplements ; Female ; Humans ; Hypocalcemia/blood ; Hypocalcemia/diagnosis ; Hypocalcemia/drug therapy ; Hypoparathyroidism/blood ; Hypoparathyroidism/diagnosis ; Male ; Middle Aged ; Parathyroid Glands/blood supply ; Parathyroid Glands/physiopathology ; Parathyroid Glands/surgery* ; Parathyroid Hormone/blood* ; Pigmentation ; Postoperative Complications/blood ; Postoperative Complications/diagnosis ; Postoperative Complications/drug therapy ; Postoperative Period ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroidectomy/adverse effects ; Thyroidectomy/methods* ; Time Factors ; Young Adult
BACKGROUND: Postoperative hypoparathyroidism is the most common complication after total thyroidectomy, owing to unintentional injury or decreased blood flow to the parathyroid glands. Prediction of postoperative hypoparathyroidism would be helpful for surgeons to manage postoperative hypocalcemia. In this study, we scored the discoloration of the parathyroid glands using a new parathyroid scoring system and evaluated the correlation between the parathyroid score and duration of required calcium supplementation after total thyroidectomy.

METHODS: A total of 316 patients undergoing total thyroidectomy between November 2009 and April 2010 were enrolled in this retrospective study. Parathyroid scoring was performed by one experienced surgeon. The status of each of the 4 parathyroid glands was classified as normal color (3 points), slightly discolored (2 points), dark discoloration (1 point), or loss of the gland (0 points), resulting in possible total scores of 0-12. Serum parathyroid hormone (PTH), serum calcium, and ionized calcium concentrations were measured at 2 hours, 2 weeks, 3 months, 6 months, and 1 year after surgery. Patients were also divided into three groups based on the duration of required calcium supplementation: no required supplementation (n = 260, 82.3%), required supplementation for <6 months (n = 38, 12%), and required supplementation for ≥6 months (n = 18, 5.75%).

RESULTS: Parathyroid scores were positively correlated with ionized PTH concentrations at 2 hours (r = 0.053, p < 0.001), 2 weeks (r = 0.056, p < 0.001), 3 months (r = 0.032, p<0.001), 6 months (r = 0.072, p < 0.001), and 1 year (r = 0.071, p < 0.001) after thyroidectomy. Parathyroid scores were significantly and inversely associated with the duration of required calcium supplementation (p = 0.001).

CONCLUSIONS: Parathyroid scores at the end of surgery might be helpful for predicting the degree of postoperative hypocalcemia after total thyroidetomy.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bup Woo(김법우) ORCID logo https://orcid.org/0000-0002-1342-9055
Kim, Seok Mo(김석모) ORCID logo https://orcid.org/0000-0001-8070-0573
Kim, Soo Young(김수영) ORCID logo https://orcid.org/0000-0002-8919-3456
Park, Cheong Soo(박정수)
Lee, Yong Sang(이용상) ORCID logo https://orcid.org/0000-0002-8234-8718
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
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