Impact of Immediate Post-Thyroidectomy Parathyroid Hormone Levels on Subsequent Serum Calcium Changes

Abstract

Background: Post-thyroidectomy hypocalcemia is a common complication, and immediate postoperative parathyroid hormone (PTH) levels may predict subsequent serum calcium changes. This study aimed to assess the impact of immediate post-thyroidectomy PTH levels on subsequent serum calcium levels. Methods: This cross-sectional study was conducted at the General Surgery and Otolaryngology Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from January 2022 to December 2023. A total of 103 patients who underwent total thyroidectomy were enrolled. Immediate postoperative PTH levels were assessed, and serum calcium levels were measured at different postoperative intervals. Results: The study analyzed 103 patients undergoing total thyroidectomy. The mean age was 41.72±12.12 years, with 76.7% females. The primary indication was multinodular goiter (70.87%). Postoperatively, PTH significantly declined (p=0.001), correlating with hypocalcemia (r=0.310, p=0.001). A PTH cutoff of ≤14.4 pg/mL predicted hypocalcemia with 94.6% sensitivity and 100% specificity. Early postoperative PTH assessment is crucial for identifying at-risk patients and guiding calcium supplementation. Conclusion: Early postoperative PTH assessment is a reliable predictor of hypocalcemia following total thyroidectomy. A PTH threshold of ≤14.4 pg/mL demonstrated high sensitivity and specificity in identifying at-risk patients. Timely intervention with calcium supplementation can prevent complications, improving postoperative management and patient outcomes.