Risk Factors of Severe Hypocalcemia after US ‐guided Percutaneous Microwave Ablation of the Parathyroid Gland in Patients with Secondary Hyperparathyroidism

ABSTRACTIdentify potential risk factors associated with severe hypocalcemia (SH) after microwave ablation (MWA) in patients with secondary hyperparathyroidism (SHPT). This retrospective cross ‐sectional study enrolled 204 consecutive patients (with 387 parathyroid glands) who underwent MWA between July 2015 and May 2018. Clinical parameters, laboratory indices and parathyroid gland characteristics were analyzed to assess risk factors associated with SH after MWA. SH was defined as seru m calcium level lower than 1.875 mmol/L (7.5 mg/dL) after MWA. Two models (I and II) for pre‐MWA and post‐MWA prediction were established respectively. In accordance with the KDIGO guidelines, the target value for iPTH less than 300 pg/ml within 7 days after MWA was considered as a succe ssful procedure. The success rate of MWA was 71.6% (146/204). The incidence of hypocalcemia and SH after MWA was 35.8% and 22.06%, respectively. The pre‐MWA prediction Model I and II showed that high pre‐MWA intact parathyroid hormone (iPTH)/ a dramatic reduction in iPTH, low pre‐MWA serum cal cium, multiple ablated gland, and lack of pruritus symptoms were risk factors for developing SH. The accuracy (82.23% vs 83.25% in Models I and II, respectively), sensitivity (34.88% vs 44.19%), specificity (95.45% vs 94.59%), positive predictive value (PPV) (68.18% vs 70.37%) and negative predictiv e value (NPV) (84.00% vs 85.37%) of both models were promising. The logistic regression fitting of the n...
Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research