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Purpose <p>Post-surgical hypoparathyroidism (POSH) is a common complication after total thyroidectomy. This study aims to assess the accuracy of serum and ionized calcium and PTH levels on the first postoperative day (POD-1) to predict postoperative hypocalcemia (PoHC), transient hypoparathyroidism (THPT), and permanent hypoparathyroidism (PtHPT).</p> Methods <p>Biochemical parameters and clinical variables were retrospectively analyzed in 200 patients. The optimal cut-off points were determined using ROC curve analysis. Results were correlated with analytical and clinical variables and patient outcomes.</p> Results <p>PoHC incidence in POD-1 was 46%; THPT and PtHPT were 37 and 9%, respectively. Ionized calcium &lt; 4.43&#xa0;mg/dL on POD-1 predicted PoHC (AUC = 0.9) better than PTH and serum calcium. PTH &lt; 8.06&#xa0;pg/mL on POD-1 predicted PtHPT (AUC = 0.797). Multivariate analysis identified PTH &lt; 21.2&#xa0;pg/mL, ionized calcium &lt; 4.43&#xa0;mg/dL, and serum calcium &lt; 8.76&#xa0;mg/dL on POD-1 as significant PoHC risk factors.</p> Conclusion <p>Ionized calcium on POD-1 predicts PoHC accurately, while serum PTH indicates higher risk for PtHPT.</p>

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Ionized calcium and PTH as predictors of hypoparathyroidism following total thyroidectomy

  • 期刊论文

  • 发表日期：

    2025年1月24日

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  • Mario Sánchez-Canteli,
  • María Pasarón Fernández,
  • María Riestra-Fermández,
  • Gala Gutiérrez-Buey,
  • Patricia Martínez-González,
  • Raquel Fernández-Morais,
  • Marta Elena Fernández-Pello,
  • Juan Carlos Álvarez-Méndez

摘要

Purpose

Post-surgical hypoparathyroidism (POSH) is a common complication after total thyroidectomy. This study aims to assess the accuracy of serum and ionized calcium and PTH levels on the first postoperative day (POD-1) to predict postoperative hypocalcemia (PoHC), transient hypoparathyroidism (THPT), and permanent hypoparathyroidism (PtHPT).

Methods

Biochemical parameters and clinical variables were retrospectively analyzed in 200 patients. The optimal cut-off points were determined using ROC curve analysis. Results were correlated with analytical and clinical variables and patient outcomes.

Results

PoHC incidence in POD-1 was 46%; THPT and PtHPT were 37 and 9%, respectively. Ionized calcium < 4.43 mg/dL on POD-1 predicted PoHC (AUC = 0.9) better than PTH and serum calcium. PTH < 8.06 pg/mL on POD-1 predicted PtHPT (AUC = 0.797). Multivariate analysis identified PTH < 21.2 pg/mL, ionized calcium < 4.43 mg/dL, and serum calcium < 8.76 mg/dL on POD-1 as significant PoHC risk factors.

Conclusion

Ionized calcium on POD-1 predicts PoHC accurately, while serum PTH indicates higher risk for PtHPT.