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- Title
Identification of novel risk factors for postoperative severe hypocalcemia in patients with primary hyperparathyroidism undergoing parathyroidectomy: a case control study.
- Authors
Xu, Jiahao; Kong, Na; Bai, Nan; Zhang, Ziqin; Cui, Aimin; Tan, Shen; Xu, Qiqi
- Abstract
Background: Patients with primary hyperparathyroidism (PHPT) are at risk for severe hypocalcemia (SH) following parathyroidectomy (PTX), but limited data exist on the predictors of SH. We aimed to identify risk factors for early postoperative SH after PTX in patients with PHPT and to evaluate the predictive value of clinical parameters. Methods: A retrospective review of patients with PHPT who underwent PTX between January 2010 and December 2022 was performed. A total of 46 patients were included in the study, with 15 (32.6%) experiencing postoperative SH, 19 (41.3%) having calculi in the ureter or kidney, and 37 (80.4%) having osteoporosis. Patients were divided into SH and non-SH groups based on postoperative serum calcium levels. Preoperative biochemical indicators, bone turnover markers, and renal function parameters were analyzed and correlated with postoperative SH. Results: Statistically significant (P < 0.05) differences were found in preoperative serum calcium (serum Ca), intact parathyroid hormone, serum phosphorus (serum P), serum Ca/P, percentage decrease of serum Ca, total procollagen type 1 intact N-terminal propeptide, osteocalcin (OC), and alkaline phosphatase levels between the two groups. Multivariate analysis showed that serum P (odds ratio [OR] = 0.989; 95% confidence interval [95% CI] = 0.981–0.996; P = 0.003), serum Ca (OR = 0.007; 95% CI = 0.001–0.415; P = 0.017), serum Ca/P (OR = 0.135; 95% CI = 0.019–0.947; P = 0.044) and OC levels (OR = 1.012; 95% CI = 1.001–1.024; P = 0.036) were predictors of early postoperative SH. The receiver operating characteristic curve analysis revealed that serum P (area under the curve [AUC] = 0.859, P < 0.001), serum Ca/P (AUC = 0.735, P = 0.010) and OC (AUC = 0.729, P = 0.013) had high sensitivity and specificity. Conclusion: Preoperative serum P, serum Ca/P and osteocalcin levels may identify patients with PHPT at risk for early postoperative SH after PTX.
- Subjects
CHINA; KIDNEY physiology; HYPERPARATHYROIDISM; PREDICTIVE tests; RISK assessment; RECEIVER operating characteristic curves; SEVERITY of illness index; RETROSPECTIVE studies; MULTIVARIATE analysis; ALKALINE phosphatase; DESCRIPTIVE statistics; HYPOCALCEMIA; SURGICAL complications; LONGITUDINAL method; CALCIUM; PARATHYROID hormone; ODDS ratio; ADRENALECTOMY; CASE-control method; CONFIDENCE intervals; BIOMARKERS; BONE remodeling; DISEASE risk factors; DISEASE complications
- Publication
BMC Endocrine Disorders, 2024, Vol 24, Issue 1, p1
- ISSN
1472-6823
- Publication type
Article
- DOI
10.1186/s12902-024-01620-6