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Pre-operative serum alkaline phosphatase as a predictive indicator of post-operative hypocalcaemia in patients undergoing total thyroidectomy

Published online by Cambridge University Press:  29 September 2015

M S Miah ,
S Mahendran ,
C Mak ,
G Leese  and
D Smith
M S Miah*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Ninewells Hospital and University of Dundee Medical School, Scotland, UK
S Mahendran
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Ninewells Hospital and University of Dundee Medical School, Scotland, UK
C Mak
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Ninewells Hospital and University of Dundee Medical School, Scotland, UK
G Leese
Affiliation:
Department of Endocrinology, Ninewells Hospital and University of Dundee Medical School, Scotland, UK
D Smith
Affiliation:
Department of General Surgery, Ninewells Hospital and University of Dundee Medical School, Scotland, UK
*
Address for correspondence: Mr M S Miah, Department of Otorhinolaryngology – Head and Neck Surgery, Ninewells Hospital and University of Dundee Medical School, Dundee DD1 9SY, Scotland, UK Fax: +44 1382 632816 E-mail: mohammedmiah@nhs.net
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Abstract

Objective:

This study aimed to evaluate whether a pre-operative elevated serum alkaline phosphatase level is a potential predictor of post-operative hypocalcaemia after total thyroidectomy.

Methods:

Data was retrospectively collected from the case notes of patients who had undergone total thyroidectomy. Patients were divided into Graves’ disease and non-Graves’ groups. Pre-operative and post-operative biochemical markers, including serum calcium, alkaline phosphatase and parathyroid hormone levels, were reviewed.

Results:

A total of 225 patients met the inclusion criteria. Graves’ disease was the most common indication (n = 134; 59.5 per cent) for thyroidectomy. Post-operative hypocalcaemia developed in 48 patients (21.3 per cent) and raised pre-operative serum alkaline phosphatase was noted in 94 patients (41.8 per cent). Raised pre-operative serum alkaline phosphatase was significantly associated with post-operative hypocalcaemia, particularly in Graves’ disease patients (p< 0.05).

Conclusion:

Pre-operative serum alkaline phosphatase measurements help to predict post-thyroidectomy hypocalcaemia, especially in patients who do not develop hypoparathyroidism. Ascertaining the pre-operative serum alkaline phosphatase level in patients undergoing total thyroidectomy may help surgeons to identify at-risk patients.

Keywords

HypocalcemiaAlkaline PhosphataseThyroidectomyGraves Disease
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 11 , November 2015 , pp. 1128 - 1132
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented as an oral presentation at the Scottish Otorhinolaryngological Society meeting, 12 May 2012, Dunblane, Scotland, UK, and as a poster at the 14th British Academic Conference in Otolaryngology, 4–6 July 2012, Glasgow, Scotland, UK

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