Early Postoperative PTH Determination as Predictor for Post-Thyroidectomy Hypocalcemia.

OBJECTIVE: Post-thyroidectomy hypocalcemia is a major complication following total thyroidectomy. This study aimed to evaluate early postoperative parathyroid hormone (PTH) measurement as a predictor of hypocalcemia after thyroidectomy and its impact on same-day discharge. METHODS: This study combined a prospective IRB-approved correlation study of 60 patients who underwent total thyroidectomy with a meta-analysis of 5 observational studies. RESULTS: Using Pearson Correlation Coefficient correlation, there was a significant positive correlation between PTH measured 1H after surgery with 4 H PTH (PCC = 0.787) and 4H Ionized Ca (PCC = 0.642). The sensitivity of early PTH measurement (cutoff < 14 pg/mL) for detecting hypocalcemia was 100%, with an AUC of 0.977 (95% CI: 0.565-1.0). Meta-analysis of previous studies confirmed a strong positive association between early PTH and late measurements. CONCLUSIONS: Early PTH measurement at 1 hour after surgery is a highly sensitive tool for detecting post-thyroidectomy hypocalcemia, which may help reduce hospital stay following thyroidectomy.