25-Hydroxyvitamin D deficiency is a risk factor for symptoms of postoperative hypocalcemia and secondary hyperparathyroidism after minimally invasive parathyroidectomy

Zoe A. Stewart, Amanda Blackford, Helina Somervell, Kent Friedman, Elizabeth Garrett-Mayer, Alan P B Dackiw, Martha A. Zeiger, William B. Inabnet, Keith S. Heller, Randall D. Gaz, Janice L. Pasieka, Kresimira Milas

Research output: Contribution to journalArticle

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Abstract

Background. Patients with primary hyperparathyroidism who undergo minimally invasive parathyroidectomy (MIP) may have postoperative symptoms of hypocalcemia or secondary hyperparathyroidism. This study sought to identify factors predictive of these events. Methods. Between 1998 and 2004, 190 patients with primary hyperparathyroidism underwent MIP with excision of a single adenoma. Age, gender, race, prior head and neck surgery, use of preoperative thyroid hormone or calcium-channel blockers, preoperative levels of calcium, 25-hydroxyvitamin D (25[OH]D) and intact parathyroid hormone (iPTH), the presence of osteopenia or osteoporosis, intraoperative iPTH levels, and adenoma weight were evaluated by univariate analysis as predictors of postoperative symptoms of hypocalcemia and secondary hyperparathyroidism. Results. None of the following were predictors of postoperative symptoms of hypocalcemia: age, gender, race, prior head and neck surgery, preoperative medications, preoperative calcium and iPTH levels, osteopenia or osteoporosis, intraoperative iPTH levels, or adenoma weight. However, patients with postoperative symptoms of hypocalcemia had significantly lower preoperative 25[OH]D levels (P = .01). Further, higher preoperative iPTH levels (P < .01) and lower preoperative 25[OH]D levels (P = .05) were associated with secondary hyperparathyroidism postoperatively. Conclusions. A low preoperative 25[OH]D level is associated with postoperative symptoms of hypocalcemia and secondary hyperparathyroidism in patients undergoing MIP. One might consider instituting empiric calcium supplementation postoperatively in patients with low 25[OH]D levels.

Original languageEnglish (US)
Pages (from-to)1018-1026
Number of pages9
JournalSurgery
Volume138
Issue number6
DOIs
StatePublished - Dec 2005

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Parathyroidectomy
Secondary Hyperparathyroidism
Hypocalcemia
Parathyroid Hormone
Parathyroid Neoplasms
Primary Hyperparathyroidism
Metabolic Bone Diseases
Calcium
Osteoporosis
Neck
Head
Weights and Measures
Calcium Channel Blockers
Thyroid Hormones
Adenoma
25-hydroxyvitamin D

ASJC Scopus subject areas

  • Surgery

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25-Hydroxyvitamin D deficiency is a risk factor for symptoms of postoperative hypocalcemia and secondary hyperparathyroidism after minimally invasive parathyroidectomy. / Stewart, Zoe A.; Blackford, Amanda; Somervell, Helina; Friedman, Kent; Garrett-Mayer, Elizabeth; Dackiw, Alan P B; Zeiger, Martha A.; Inabnet, William B.; Heller, Keith S.; Gaz, Randall D.; Pasieka, Janice L.; Milas, Kresimira.

In: Surgery, Vol. 138, No. 6, 12.2005, p. 1018-1026.

Research output: Contribution to journalArticle

Stewart, ZA, Blackford, A, Somervell, H, Friedman, K, Garrett-Mayer, E, Dackiw, APB, Zeiger, MA, Inabnet, WB, Heller, KS, Gaz, RD, Pasieka, JL & Milas, K 2005, '25-Hydroxyvitamin D deficiency is a risk factor for symptoms of postoperative hypocalcemia and secondary hyperparathyroidism after minimally invasive parathyroidectomy', Surgery, vol. 138, no. 6, pp. 1018-1026. https://doi.org/10.1016/j.surg.2005.09.018
Stewart, Zoe A. ; Blackford, Amanda ; Somervell, Helina ; Friedman, Kent ; Garrett-Mayer, Elizabeth ; Dackiw, Alan P B ; Zeiger, Martha A. ; Inabnet, William B. ; Heller, Keith S. ; Gaz, Randall D. ; Pasieka, Janice L. ; Milas, Kresimira. / 25-Hydroxyvitamin D deficiency is a risk factor for symptoms of postoperative hypocalcemia and secondary hyperparathyroidism after minimally invasive parathyroidectomy. In: Surgery. 2005 ; Vol. 138, No. 6. pp. 1018-1026.
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abstract = "Background. Patients with primary hyperparathyroidism who undergo minimally invasive parathyroidectomy (MIP) may have postoperative symptoms of hypocalcemia or secondary hyperparathyroidism. This study sought to identify factors predictive of these events. Methods. Between 1998 and 2004, 190 patients with primary hyperparathyroidism underwent MIP with excision of a single adenoma. Age, gender, race, prior head and neck surgery, use of preoperative thyroid hormone or calcium-channel blockers, preoperative levels of calcium, 25-hydroxyvitamin D (25[OH]D) and intact parathyroid hormone (iPTH), the presence of osteopenia or osteoporosis, intraoperative iPTH levels, and adenoma weight were evaluated by univariate analysis as predictors of postoperative symptoms of hypocalcemia and secondary hyperparathyroidism. Results. None of the following were predictors of postoperative symptoms of hypocalcemia: age, gender, race, prior head and neck surgery, preoperative medications, preoperative calcium and iPTH levels, osteopenia or osteoporosis, intraoperative iPTH levels, or adenoma weight. However, patients with postoperative symptoms of hypocalcemia had significantly lower preoperative 25[OH]D levels (P = .01). Further, higher preoperative iPTH levels (P < .01) and lower preoperative 25[OH]D levels (P = .05) were associated with secondary hyperparathyroidism postoperatively. Conclusions. A low preoperative 25[OH]D level is associated with postoperative symptoms of hypocalcemia and secondary hyperparathyroidism in patients undergoing MIP. One might consider instituting empiric calcium supplementation postoperatively in patients with low 25[OH]D levels.",
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T1 - 25-Hydroxyvitamin D deficiency is a risk factor for symptoms of postoperative hypocalcemia and secondary hyperparathyroidism after minimally invasive parathyroidectomy

AU - Stewart, Zoe A.

AU - Blackford, Amanda

AU - Somervell, Helina

AU - Friedman, Kent

AU - Garrett-Mayer, Elizabeth

AU - Dackiw, Alan P B

AU - Zeiger, Martha A.

AU - Inabnet, William B.

AU - Heller, Keith S.

AU - Gaz, Randall D.

AU - Pasieka, Janice L.

AU - Milas, Kresimira

PY - 2005/12

Y1 - 2005/12

N2 - Background. Patients with primary hyperparathyroidism who undergo minimally invasive parathyroidectomy (MIP) may have postoperative symptoms of hypocalcemia or secondary hyperparathyroidism. This study sought to identify factors predictive of these events. Methods. Between 1998 and 2004, 190 patients with primary hyperparathyroidism underwent MIP with excision of a single adenoma. Age, gender, race, prior head and neck surgery, use of preoperative thyroid hormone or calcium-channel blockers, preoperative levels of calcium, 25-hydroxyvitamin D (25[OH]D) and intact parathyroid hormone (iPTH), the presence of osteopenia or osteoporosis, intraoperative iPTH levels, and adenoma weight were evaluated by univariate analysis as predictors of postoperative symptoms of hypocalcemia and secondary hyperparathyroidism. Results. None of the following were predictors of postoperative symptoms of hypocalcemia: age, gender, race, prior head and neck surgery, preoperative medications, preoperative calcium and iPTH levels, osteopenia or osteoporosis, intraoperative iPTH levels, or adenoma weight. However, patients with postoperative symptoms of hypocalcemia had significantly lower preoperative 25[OH]D levels (P = .01). Further, higher preoperative iPTH levels (P < .01) and lower preoperative 25[OH]D levels (P = .05) were associated with secondary hyperparathyroidism postoperatively. Conclusions. A low preoperative 25[OH]D level is associated with postoperative symptoms of hypocalcemia and secondary hyperparathyroidism in patients undergoing MIP. One might consider instituting empiric calcium supplementation postoperatively in patients with low 25[OH]D levels.

AB - Background. Patients with primary hyperparathyroidism who undergo minimally invasive parathyroidectomy (MIP) may have postoperative symptoms of hypocalcemia or secondary hyperparathyroidism. This study sought to identify factors predictive of these events. Methods. Between 1998 and 2004, 190 patients with primary hyperparathyroidism underwent MIP with excision of a single adenoma. Age, gender, race, prior head and neck surgery, use of preoperative thyroid hormone or calcium-channel blockers, preoperative levels of calcium, 25-hydroxyvitamin D (25[OH]D) and intact parathyroid hormone (iPTH), the presence of osteopenia or osteoporosis, intraoperative iPTH levels, and adenoma weight were evaluated by univariate analysis as predictors of postoperative symptoms of hypocalcemia and secondary hyperparathyroidism. Results. None of the following were predictors of postoperative symptoms of hypocalcemia: age, gender, race, prior head and neck surgery, preoperative medications, preoperative calcium and iPTH levels, osteopenia or osteoporosis, intraoperative iPTH levels, or adenoma weight. However, patients with postoperative symptoms of hypocalcemia had significantly lower preoperative 25[OH]D levels (P = .01). Further, higher preoperative iPTH levels (P < .01) and lower preoperative 25[OH]D levels (P = .05) were associated with secondary hyperparathyroidism postoperatively. Conclusions. A low preoperative 25[OH]D level is associated with postoperative symptoms of hypocalcemia and secondary hyperparathyroidism in patients undergoing MIP. One might consider instituting empiric calcium supplementation postoperatively in patients with low 25[OH]D levels.

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U2 - 10.1016/j.surg.2005.09.018

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JF - Surgery (United States)

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