Niveles de calcemia y paratohormona relacionados con manifestaciones clinicas de hipocalcemia en el postoperatorio de tiroidectomía total. Hospital José Carrasco Arteaga, Cuenca 2013-2016

Abstract

Background: The decrease in calcium and parathyroid hormone levels are related to clinical manifestations in patients undergoing total thyroidectomy and can vary from hours to days, from paresthesias to tetany. Hypocalcemia can also be assessed biochemically with blood levels of calcium and parathormone. Objective: To determine the levels of calcemia and paratohormone related to clinical manifestations of hypocalcemia in the postoperative period of total thyroidectomy. Methods and materials: observational analytical cross-sectional cohort study conducted at the Hospital José Carrasco Arteaga between 2013-2016. The studied population was formed by the universe 300 patients. Clinical records of patients with total thyroidectomy were included; information on sex, age, paresthesias, Chvostek's sign and Trousseau was collected; type of thyroidectomy, operative time, calcium and parathyroid hormone levels. Association, OR and bivariate analysis were determined. Results: Clinical manifestations were found in 29% (87 patients). The most committed age group was 40 to 64 years old. The women were the most affected. The operative time was not associated with clinical manifestations OR 0.66 (95% CI: 0.23-1.84 p value 0.42). Total thyroidectomy with ganglionic dissection of level VI was associated with hypocalcemic symptoms OR 2.22 (95% CI: 1.25-3.93 p-value 0.005). There was also an association between having clinical manifestations of hypocalcemia with: low levels of calcium and parathyroid hormone OR 2.23 (95% CI: 1.33-3.74 p-value 0.002), OR 3.75 (95% CI: 2.19-6.40 p-value 0.000) respectively. Conclusion: The decrease in the values of calcemia and paratohormone if they are related to the clinical manifestations of hypocalcemia