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Paper 7 (1030)
25-HYDROXY VITAMIN D DEFICIENCY IS A RISK FACTOR FOR POSTOPERATIVE HYPOCALCEMIA AFTER MINIMALLY INVASIVE PARATHYROIDECTOMY
Background: Many patients with primary hyperparathyroidism who undergo minimally invasive parathyroidectomy (MIP) have post-operative symptoms of hypocalcemia. The aim of this study was to identify risk factors predictive of hypocalcemia after MIP.
The 26th Annual Meeting of the American
Association of Endocrine Surgeons
April 3rd- 5th,2005 - Paradisus Riviera Cancun.
Zoe Stewart, MD, PhD, Helina Somervell, CRNP, Amanda Blackford, ScM, Elizabeth Garrett-Mayer, PhD, Kent Friedman, MD, Alan Dackiw, MD, PhD & Martha Zeiger, MD
Johns Hopkins Medical Institution, Baltimore, Maryland
Methods: Of 255 consecutive patients operated on for primary hyperparathyroidism between 1998 and 2004, 124 underwent MIP with excision of a single adenoma. Pre-operative levels of 25-hydroxy vitamin D and parathyroid hormone (PTH), the presence of osteopenia or osteoporosis, intra-operative changes in PTH levels, and weight of the adenoma were evaluated by univariate analysis as potential predictors of post-operative hypocalcemia.
Results: Pre-operative 25-hydroxy vitamin D levels were significantly lower in patients with post-operative hypocalcemia than in patients with normocalcemia (p=0.008). Neither osteopenia nor osteoporosis was associated with post-operative hypocalcemia (p=1.00). Furthermore, neither pre-operative PTH levels (p=0.57), a rapid decline in intra-operative PTH (p=0.42) nor weight of the adenoma (p=0.67) were independent predictors of post-operative hypocalcemia.
Conclusions: A low pre-operative 25-hydroxy vitamin D level is an independent predictor of post-operative hypocalcemia in patients undergoing MIP. We recommend that all patients have 25-hydroxy vitamin D level measured pre-operatively to facilitate prevention of hypocalcemia after MIP.