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Prevalence and Predictors of Postoperative Hypoparathyroidism: A Multicenter Observational Study
Reem J Al Argan1,2, Dania M Alkhafaji1,2, Shaya Y AlQahtani1,3
1Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Eastern Province, Saudi Arabia.
Journal of Clinical Medicine
|April 12, 2025
Summary
Post-thyroid surgery hypoparathyroidism (HPT) is common, affecting 35.3% of patients. Surgical extent and low parathyroid hormone (PTH) levels predict HPT, with central lymph node dissection strongly predicting permanent HPT.
Area of Science:
- Endocrinology
- Surgical Oncology
- Neurosurgery
Background:
- Post-thyroid surgery hypoparathyroidism (HPT) is a frequent complication, potentially causing long-term morbidity.
- The incidence of HPT following thyroid surgery can be as high as 29%.
Purpose of the Study:
- To investigate the prevalence and predictors of HPT after thyroid surgery.
- To identify factors associated with both transient and permanent HPT.
Main Methods:
- A retrospective, multicenter observational study of 679 patients undergoing thyroid surgery between 2016 and 2022.
- Analysis of demographic data, surgical details, pathology, and postoperative calcium and parathyroid hormone (PTH) levels.
- Multivariate analysis to identify independent predictors of HPT, with statistical significance set at p < 0.05.
Main Results:
- HPT occurred in 35.3% of cases (228/679), with 81% being transient and 19% permanent.
- Total thyroidectomy (OR 2.7), completion thyroidectomy (OR 8.4), and low immediate postoperative PTH (OR 3.1) predicted HPT.
- Central lymph node dissection (CLND; OR 4.03) and low postoperative PTH (OR 2.56) predicted permanent HPT.
Conclusions:
- Surgical extent and low postoperative PTH levels are key predictors of HPT.
- CLND and low postoperative PTH levels are the strongest predictors of permanent HPT.
- Risk assessment and early PTH level measurement can help minimize HPT occurrence and guide intervention.
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