Identification of Patients at High Risk for Postsurgical Hypoparathyroidism

Postsurgical hypoparathyroidism (PostHypo) is a common complication after total thyroidectomy. We studied the risk factors associated with PostHypo.

The study included 109 women, (mean age: 50.7±10.75 years), who underwent total thyroidectomy for thyroid diseases.

Based on the development of biochemical hypocalcemia on the first postoperative day following total thyroidectomy, (cCa<8.4 mg/dl), 37 women developed PostHypo and 72 did not. Younger age, a lower preoperative corrected calcium and the presence of parathyroid glands in the specimens were related to the development of PostHypo. Of all patients, 51.4% had a vitamin D deficiency. A parathyroid hormone (PTH) value ≤9.4 pg/ml was 84.9% sensitive and 71.4% specific to predict PostHypo on the 1^st postoperative day. A 50% reduction of the PTH value on the 1^st postoperative day from the preoperative level could identify patients who develop PostHypo with 76% sensitivity and 75% specificity.

PTH postoperative measurement and its alteration from the preoperative level can be used to identify patients who are at increased risk to develop PostHypo.