Predicción del comportamiento biológico de los niveles de calcio tras tiroidectomía mediante modelos matemáticos

Résumé

Postoperative hypocalcaemia is a frequent and potentially severe complication of thyroid surgery. Its origin is the extirpation of parathyroid glands or the damage of their vascularization and, due to the particular physiology of calcium metabolism, can appear even beyond 48h after surgery, so its prediction within the patient's hospital stay would be of great utility. Several models have been proposed for this estimation, based on the number of seen parathyroid glands during surgery, the decrease of calcium level after the first hours or, more recently, the change of PTH levels after the procedure. In this study we evaluate 192 patients undergoing total thyroidectomy between 2003 and 2012 in the ENT Department of the University Hospital of Badajoz. Along several stages a mathematical model, based on differential equations, is built with the aim of predicting the minimum level of calcium and tracing an estimation curve that represents the biologic behaviour of these levels during the first four days after the procedure. The results obtained with the model described are compared with those of the existing models in literature.