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open access

Vol 73, No 1 (2022)
Original paper
Submitted: 2021-07-09
Accepted: 2021-09-20
Published online: 2022-02-08
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Intact parathyroid hormone value on the first postoperative day following total thyroidectomy as a predictor of permanent hypoparathyroidism: a retrospective analysis on 426 consecutive patients

Gian Luigi Canu1, Fabio Medas1, Federico Cappellacci1, Cristina Soddu1, Giorgio Romano2, Enrico Erdas1, Pietro Giorgio Calò1
DOI: 10.5603/EP.a2022.0005
·
Pubmed: 35156703
·
Endokrynol Pol 2022;73(1):48-55.
Affiliations
  1. Department of Surgical Sciences, University of Cagliari, “Policlinico Universitario Duilio Casula”, Monserrato, Italy
  2. Department of Surgical, Oncological and Oral Sciences, Section of General and Urgent Surgery, University of Palermo, Palermo, Italy, Palermo, Italy

open access

Vol 73, No 1 (2022)
Original Paper
Submitted: 2021-07-09
Accepted: 2021-09-20
Published online: 2022-02-08

Abstract

Introduction: Hypoparathyroidism represents a common complication following total thyroidectomy. To date, there is still no reliable and immediate postoperative parameter to establish which patients with postsurgical hypoparathyroidism will develop permanent hypoparathyroidism.

The main purpose of the present study was to assess whether the intact parathyroid hormone (iPTH) value on the first postoperative day is a good predictor of permanent hypoparathyroidism.

Material and methods: Patients undergoing thyroidectomy in our unit between March 2018 and January 2020 were analysed. According to the iPTH value on the first postoperative day and on the basis of the detection threshold of the iPTH test used, patients were divided into two groups: Group A (iPTH ≥ 4.6 pg/mL) and Group B (iPTH < 4.6 pg/mL, undetectable).

Results: In total 426 patients were included: 364 in Group A and 62 in Group B. Permanent hypoparathyroidism occurred in 3 (0.82%) patients from Group A and in 26 (41.94%) from Group B (p < 0.001). When iPTH levels were < 4.6 pg/mL on the first postoperative day the sensitivity for the prediction of permanent hypoparathyroidism was 89.66%, the specificity was 90.93%, the positive predictive value (PPV) was 41.94%, the negative predicitive value (NPV) was 99.18% and the accuracy was 90.85%.

Conclusions: An iPTH value < 4.6 pg/mL on the first postoperative day following total thyroidectomy has proven to be a good parameter for early identification of patients at high risk for permanent hypoparathyroidism. Moreover, we want to underline that in our experience no patient with an iPTH level > 6.5 pg/mL developed this complication.

 

Abstract

Introduction: Hypoparathyroidism represents a common complication following total thyroidectomy. To date, there is still no reliable and immediate postoperative parameter to establish which patients with postsurgical hypoparathyroidism will develop permanent hypoparathyroidism.

The main purpose of the present study was to assess whether the intact parathyroid hormone (iPTH) value on the first postoperative day is a good predictor of permanent hypoparathyroidism.

Material and methods: Patients undergoing thyroidectomy in our unit between March 2018 and January 2020 were analysed. According to the iPTH value on the first postoperative day and on the basis of the detection threshold of the iPTH test used, patients were divided into two groups: Group A (iPTH ≥ 4.6 pg/mL) and Group B (iPTH < 4.6 pg/mL, undetectable).

Results: In total 426 patients were included: 364 in Group A and 62 in Group B. Permanent hypoparathyroidism occurred in 3 (0.82%) patients from Group A and in 26 (41.94%) from Group B (p < 0.001). When iPTH levels were < 4.6 pg/mL on the first postoperative day the sensitivity for the prediction of permanent hypoparathyroidism was 89.66%, the specificity was 90.93%, the positive predictive value (PPV) was 41.94%, the negative predicitive value (NPV) was 99.18% and the accuracy was 90.85%.

Conclusions: An iPTH value < 4.6 pg/mL on the first postoperative day following total thyroidectomy has proven to be a good parameter for early identification of patients at high risk for permanent hypoparathyroidism. Moreover, we want to underline that in our experience no patient with an iPTH level > 6.5 pg/mL developed this complication.

 

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Keywords

thyroidectomy; permanent hypoparathyroidism; complications; intact parathyroid hormone

About this article
Title

Intact parathyroid hormone value on the first postoperative day following total thyroidectomy as a predictor of permanent hypoparathyroidism: a retrospective analysis on 426 consecutive patients

Journal

Endokrynologia Polska

Issue

Vol 73, No 1 (2022)

Article type

Original paper

Pages

48-55

Published online

2022-02-08

Page views

5421

Article views/downloads

433

DOI

10.5603/EP.a2022.0005

Pubmed

35156703

Bibliographic record

Endokrynol Pol 2022;73(1):48-55.

Keywords

thyroidectomy
permanent hypoparathyroidism
complications
intact parathyroid hormone

Authors

Gian Luigi Canu
Fabio Medas
Federico Cappellacci
Cristina Soddu
Giorgio Romano
Enrico Erdas
Pietro Giorgio Calò

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