Introduction Hypocalcemia is a well-known complication after total thyroidectomy. Studies have indicated that the presence of low postoperative parathyroid hormone (PTH) levels can predict hypocalcemia. However, deﬁnitive study designs are lacking. The aim of this study was to determine whether postoperative PTH alone can accurately predict postoperative biochemical hypocalcemia. Methods Under IRB approval, a prospective study of 218 consecutive patients who underwent total or completion thyroidectomy by two surgeons between June 2014 and June 2016 was performed. Biochemical hypocalcemia was deﬁned as ionized calcium \1.13 mmol/L or serum calcium \8.4 mg/dL at any time postoperatively. Three PTH thresholds, \10, \20 pg/mL, and [50% drop in PTH 1 h postoperatively from baseline were examined. Results Postoperative PTH \ 10 pg/mL had a sensitivity of 36.5% (95% CI 27.4–46.3%) and a speciﬁcity of 89.2% (95% CI 81.9–94.3%). Postoperative PTH \ 20 pg/mL had a sensitivity of 66.4% (95% CI 56.6–75.2%) and a speciﬁcity of 67.6% (95% CI 58.0–76.2%). Postoperative PTH decrease[50% had a sensitivity of 63.4% (95% CI 53.2–72.7%) and a speciﬁcity of 72.5% (95% CI 62.5–81.0%). Across all PTH thresholds, the false-negative rate was 33.6–63.5% indicating that up to 64% of patients with a normal PTH level could have been
World Journal of Surgery – Springer Journals
Published: Dec 31, 2017
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