PARATHYROID HORMONE AFTER THYROIDECTOMY AS A PREDICTOR OF POST-OPERATIVE HYPOCALCEMIA

Background: Hypocalcemia is a frequent electrolyte abnormality encountered in surgical and medical practice. It can become life-threatening if unrecognized, particularly following thyroidectomy, where it contributes to prolonged hospitalization and increased readmission rates. Early identification of patients at risk is therefore essential. Recent evidence suggests that postoperative parathyroid hormone (PTH) levels may serve as a reliable predictor of subsequent hypocalcemia. Aim: To evaluate postoperative PTH levels as a predictor of hypocalcemia following thyroidectomy. Patients and Methods: A cross-sectional study with a prospective component was conducted over one year in the surgical department of Al-Yarmouk Teaching Hospital. Ninety-six patients scheduled for thyroid surgery and meeting eligibility criteria were included. Serum calcium and PTH levels were measured preoperatively and at 3, 24, and 48 hours postoperatively, in addition to a follow-up assessment at 10 days. A p-value ≤ 0.05 was considered statistically significant. Results: Females represented the majority of participants. The prevalence of hypocalcemia was 21.9% at 3 hours post-surgery. A significant reduction in postoperative calcium and PTH levels was observed compared with baseline, persisting through the 3-, 24-, 48-hour, and 10-day assessments. No significant associations were found between hypocalcemia and demographic or clinical factors including age, gender, ethnicity, residency, disease type or duration, surgical procedure, or number of preserved parathyroid glands. However, calcium levels showed a significant correlation with PTH at all postoperative time points. Conclusion: Post-thyroidectomy hypocalcemia is common. Early postoperative PTH levels correlate strongly with calcium decline and may serve as a useful predictor for identifying patients at risk.