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Design of a predictive score to assess the risk of developing hypocalcemia after total thyroidectomy. A retrospective study

Authors Papanastasiou A, Sapalidis K, Mantalobas S, Atmatzidis S, Michalopoulos N, Surlin V, Katsaounis A, Amaniti A, Zarogoulidis P, Passos I, Koulouris C, Pavlidis E, Giannakidis D, Mogoanta S, Kosmidis C, Kesisoglou I

Received 10 February 2019

Accepted for publication 3 May 2019

Published 20 May 2019 Volume 2019:12 Pages 187—192


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Anastasios Papanastasiou,1 Konstantinos Sapalidis,1 Stylianos Mantalobas,1 Stefanos Atmatzidis,1 Nikolaos Michalopoulos,1 Valeriu Surlin,1 Athanasios Katsaounis,1 Aikaterini Amaniti,1 Paul Zarogoulidis,1 Ioannis Passos,1 Charilaos Koulouris,1 Efstathios Pavlidis,1 Dimitrios Giannakidis,1 Stelian Mogoanta,2 Christoforos Kosmidis,1 Isaak Kesisoglou1

13rd Department of Surgery, “AHEPA” University Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece; 2Department of Surgery, Faculty of Dentistry, University of Medicine and Pharmacy of Craiova, Craiova, Romania

Background: Temporary hypocalcemia is the most common complication in patients after total thyroidectomy. To date, according to the literature, various predictors of the above complication have been proposed, but none of them seems to be effective enough.
Objectives: The aim of this study was to develop a reliable predictive tool for biochemical hypocalcemia in the first 48 hrs after total thyroidectomy without central dissection by analyzing several parameters relevant to this operation and to suggest a new score.
Methods: A retrospective study was performed on patients who had undergone total thyroidectomy without central neck dissection from October 2017 until January 2018. Data were collected from 36 patients and studied if there was a statistically significant relationship between the risk of hypocalcemia and 10 preselected prognostic factors.
Results: The prognostic score was formed, which included the 6 factors that showed a statistically significant relationship. Moreover, an extensive check of the predictive value of the above score was performed. It was found, therefore, that at a value of 3 and above the sensitivity was 100%, the specificity 79.16%, the positive prognostic value (PPV) 70.58% and the negative predictive value (NPV) 100%.
Conclusions: High sensitivity of CaReBe’S TiP score makes it feasible to predict patients with postoperative hypocalcemia. High NPV would allow surgeons to exclude patients with a score less than 3 from supplementary calcium medication and achieve a shorter hospitalization for them.

Keywords: design, thyroidectomy, hypocalcemia, prognostic factors

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