||The preoperative prediction of postoperative symptomatic hypocalcemia in patients with Graves' disease.
Kobayashi, Shinichiro Minami, Shigeki ,
Yamanouchi, Kosho ,
Hayashida, Naomi ,
Sakimura, ChikaEguchi, Susumu
Acta medica Nagasakiensia
5 , 2015-07 , Nagasaki University School of Medicine
In Graves' disease, one of the postoperative complications of surgical treatment is symptomatic hypocalcemia, which is defined as symptoms of hypocalcemia such as tetany, paresthesia, and muscle cramps. The aim of this study was to evaluate the preoperative factors predicting the development of symptomatic hypocalcemia after thyroidectomy in Graves' patients. One hundred nine patients with Graves' disease underwent surgery between January 2005 and August 2010 in our department. We investigated the relationship between postoperative symptomatic hypocalcemia and the serum levels of preoperative thyroid hormones, preoperative biochemical tests, and operating states in these patients. A univariate analysis determined that the preoperative serum free triiodothyronine (T3), free thyroxin (T4), and alkaline phosphatase (ALP) levels before the administration of potassium iodide were significantly higher in the symptomatic hypocalcemia patients. A multivariate analysis shows the preoperative serum free T4 level before the administration of potassium iodide to also be significantly higher in the symptomatic hypocalcemia patients. In conclusion, the preoperative serum free T4 level before the administration of potassium iodide was thus determined to be a risk factor for developing postoperative symptomatic hypocalcemia.