Risk Factors for Hypoparathyroidism after Thyroid Surgery: A Single-Center Study

Area of Science:

• Endocrinology
• Surgical Oncology
• Thyroid Surgery

Background:

• Hypoparathyroidism is a frequent complication following thyroidectomy.
• Identifying risk factors for postoperative hypoparathyroidism is crucial for patient management.

Purpose of the Study:

• To evaluate the incidence of postoperative hypoparathyroidism.
• To identify potential risk factors associated with this complication after thyroid surgery.

Main Methods:

• Retrospective study of 734 patients undergoing thyroid surgery (2018-2021).
• Assessed 6-hour postoperative parathyroid hormone (PTH) levels.
• Grouped patients based on PTH levels (≤12 pg/mL vs. >12 pg/mL).

Main Results:

• 31.3% of patients (230/734) had low postoperative PTH (<12 pg/mL).
• Risk factors included female sex, age < 40, neck dissection, lymph node yield, and incidental parathyroidectomy.
• Incidental parathyroidectomy (16.6%) correlated with thyroid cancer and neck dissection.

Conclusions:

• Younger patients, neck dissection, and incidental parathyroidectomy increase hypoparathyroidism risk.
• Incidental parathyroidectomy doesn't always lead to hypocalcemia.
• Pathogenesis is multifactorial, possibly including impaired parathyroid gland vascularity.