Early Predictors of Post - Thyroidectomy Hypoparathyroidism

Area of Science:

• Endocrine Surgery
• Surgical Oncology

Background:

• Thyroidectomy is a common endocrine surgery.
• Postoperative hypoparathyroidism remains a challenge.
• Accurate risk prediction is needed.

Purpose of the Study:

• Identify biochemical markers for hypoparathyroidism risk.
• Determine risk factors for postoperative hypoparathyroidism.

Main Methods:

• Prospective study of 142 total thyroidectomy patients.
• Measured serum intact parathyroid hormone (iPTH), calcium, phosphate, and magnesium preoperatively and postoperatively.
• Analyzed diagnostic accuracy using ROC curves and multivariate analysis.

Main Results:

• 25 (17.6%) patients developed hypoparathyroidism.
• iPTH at 6h (AUC 0.942) and ΔiPTH at 6h (AUC 0.930) showed high diagnostic accuracy.
• Higher preoperative Ca and iPTH levels were protective; a 1% iPTH decline increased risk by 15%.

Conclusions:

• Postoperative hypoparathyroidism risk is indicated by ΔiPTH at 6h > 65% or iPTH at 6h <1.57 pmol/l.
• Postoperative iPTH decline is an independent risk factor.
• Preoperative Ca and iPTH are protective factors.