Measurement of serum intact parathyroid hormone concentration 1 day after total thyroidectomy to assess risk of permanent hypoparathyroidism

• Published in: Journal of international medical research 2020-06, Vol.48 (6), p.300060520927199-300060520927199
• Main Authors: Zheng, Jianwei, Cai, Shuyan, Song, Huimin, Wang, Yunlei, Han, Xiaofeng, Han, Gang, Wu, Haoliang, Gao, Zhigang
• Format: Article
• Language: English
• Subjects: Adult; Calcium - blood; Female; Follow-Up Studies; Humans; Hypoparathyroidism - blood; Hypoparathyroidism - epidemiology; Hypoparathyroidism - etiology; Male; Middle Aged; Parathyroid Hormone - blood; Postoperative Complications - blood; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Period; Predictive Value of Tests; Reference Values; Retrospective Clinical Research Report; Retrospective Studies; Risk Assessment - methods; Risk Factors; Thyroid Neoplasms - surgery; Thyroidectomy; Thyroidectomy - adverse effects; Time Factors
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060520927199

Objective This study was performed to assess the clinical value of measuring the intact parathyroid hormone (iPTH) concentration 1 day after total thyroidectomy to estimate the occurrence of permanent hypoparathyroidism (pHPP). Methods Data of 546 patients who underwent total thyroidectomy from February 2008 to December 2018 were retrospectively analyzed. Calcium and iPTH concentrations were collected preoperatively and at 1 day and 6 months postoperatively. Logistic regression was used to analyze the correlation between clinical indexes and postoperative pHPP. Results Of the 546 patients, 22 (4.03%) developed pHPP. Multivariate analysis showed that the iPTH and serum calcium concentrations measured 1 day after surgery were independent predictors of the risk of pHPP. An iPTH concentration of 5.51 pg/mL measured 1 day postoperatively was used as the cut-off value, and the area under the curve was 0.956. The risk of pHPP was identified with a sensitivity of 100%, specificity of 85.1%, positive predictive value of 22%, and negative predictive value of 100%. Conclusions The iPTH concentration measured 1 day after total thyroidectomy is closely related to the occurrence of pHPP postoperatively and is an independent predictive risk factor. The postoperative iPTH concentration can be helpful in identifying patients at risk for developing pHPP.