Introduction
Methods
Results
Parameters | Yes (n = 51) | p value |
---|---|---|
Age (Years)
| 47.27 ± 13.69 | 0.2621 |
Age
| 0.8992 | |
21–30 Years | 4 (7.8%) | |
31–40 Years | 15 (29.4%) | |
41–50 Years | 13 (25.5%) | |
51–60 Years | 7 (13.7%) | |
61–70 Years | 9 (17.6%) | |
71–80 Years | 3 (5.9%) | |
Gender
| 0.7132 | |
Male | 7 (13.7%) | |
Female | 44 (86.3%) | |
Neck Swelling (Yes)
| 48 (94.1%) | 0.5622 |
Pressure Symptoms
| 0.7112 | |
No | 48 (94.1%) | |
Horseness Of Voice | 1 (2.0%) | |
Dysphagia With Stridor | 1 (2.0%) | |
Shortness Of Breath | 1 (2.0%) | |
TFT
| 1.0002 | |
Normal | 50 (98.0%) | |
Hypothyroidism | 1 (2.0%) | |
USG Neck
| 0.8872 | |
Tirads 1 | 5 (9.8%) | |
Tirads 2 | 21 (41.2%) | |
Tirads 3 | 1 (2.0%) | |
Tirads 4 | 17 (33.3%) | |
Tirads 5 | 5 (9.8%) | |
Thyroiditis | 1 (2.0%) | |
Solitary Thyroid Nodule | 1 (2.0%) | |
FNAC: Colloid Goiter (Yes)
| 21 (41.2%) | 0.0923 |
FNAC: Adenomatoid Nodule (Yes)
| 4 (7.8%) | 1.0002 |
FNAC: Papillary Carcinoma (Yes)
| 8 (15.7%) | 0.1862 |
FNAC: Nodular Goiter (Yes)
| 2 (3.9%) | 1.0002 |
FNAC: Follicular Neoplasm (Yes)
| 8 (15.7%) | 0.4772 |
FNAC: Thyroiditis (Yes)
| 3 (5.9%) | 0.5682 |
FNAC: Others (Yes)
| 6 (11.8%) | 0.6702 |
Procedure
| 1.0002 | |
Near Total Thyroidectomy | 5 (9.8%) | |
Total Thyroidectomy | 46 (90.2%) | |
Parathyroid (Preserved)
| 51 (100.0%) | 1.0003 |
Inferior Thyroid Artery (Preserved)
| 51 (100.0%) | 1.0003 |
Vitamin D (ng/mL) (Pre-Operative)
| 19.18 ± 9.09 | 0.2164 |
Vitamin D (Pre-Operative)
| 0.3852 | |
<20 ng/mL | 33 (64.7%) | |
20–30 ng/mL | 14 (27.5%) | |
≥30 ng/mL | 4 (7.8%) | |
PTH (pg/mL) (Pre-Operative)
| 48.05 ± 20.03 | 0.8484 |
PTH (pg/mL) (Post-Operative 4 h)***
| 19.00 ± 16.02 | 0.0014 |
PTH (Pre-Operative)
| 0.7152 | |
15–65 pg/mL | 42 (82.4%) | |
>65 pg/mL | 9 (17.6%) | |
PTH (Post-Operative 4 h)***
| < 0.0013 | |
<15 pg/mL | 28 (54.9%) | |
15–65 pg/mL | 23 (45.1%) | |
Calcium (mg/dL) (Pre-Operative)
| 9.04 ± 0.44 | 0.2304 |
Calcium (mg/dL) (POD 1)***
| 8.16 ± 0.57 | < 0.0011 |
Calcium (mg/dL) (POD 2–4)***
| 7.78 ± 0.60 | < 0.0014 |
Calcium (mg/dL) (3 Months)
| 8.99 ± 0.87 | 0.0614 |
Biochemical Hypocalcemia (Pre-Operative) (Yes)
| 8 (15.7%) | 0.1012 |
Biochemical Hypocalcemia (POD 1) (Yes)***
| 42 (60.0%) | < 0.0013 |
Biochemical Hypocalcemia (POD 2–4) (Yes)***
| 51 (73.9%) | < 0.0013 |
Biochemical Hypocalcemia (3 Months) (Yes)
| 10 (22.7%) | 0.0982 |
Symptomatic Hypocalcemia (Yes)***
| 25 (49.0%) | 0.0013 |
Post Operative Complications
| 1.0002 | |
No | 49 (96.1%) | |
Horseness Of Voice | 2 (3.9%) | |
Post Operative Management: No (Yes)
| 9 (17.6%) | 0.1022 |
Post Operative Management: IV Calcium (Yes)***
| 18 (35.3%) | 0.0152 |
Post Operative Management: Oral Calcium (Yes)
| 41 (80.4%) | 0.1212 |
Post Operative Management: Vitamin D (Yes)
| 14 (27.5%) | 0.5282 |
Discharged with Calcium Supplementation: No (Yes)
| 9 (18.4%) | 0.2052 |
Discharged with oral Calcium and vitamin DSupplementation
| 40 (81.6%) | 0.2052 |
Final HPE Impression
| 1.0003 | |
Benign | 34 (66.7%) | |
Malignant | 17 (33.3%) | |
Change in PTH (pg/mL) (Post-Operative 4 h)***
| -29.05 ± 22.81 | 0.0324 |
Parameters | Yes (n = 26) | P value |
---|---|---|
Age (Years)
| 44.65 ± 13.74 | 0.5181 |
Age
| 0.6822 | |
21–30 Years | 4 (15.4%) | |
31–40 Years | 8 (30.8%) | |
41–50 Years | 6 (23.1%) | |
51–60 Years | 3 (11.5%) | |
61–70 Years | 3 (11.5%) | |
71–80 Years | 2 (7.7%) | |
Gender
| 0.7342 | |
Male | 3 (11.5%) | |
Female | 23 (88.5%) | |
Neck Swelling (Yes)
| 25 (96.2%) | 1.0002 |
Pressure Symptoms
| 0.4412 | |
No | 25 (96.2%) | |
Horseness Of Voice | 0 (0.0%) | |
Dysphagia With Stridor | 0 (0.0%) | |
Shortness Of Breath | 1 (3.8%) | |
TFT
| 1.0002 | |
Normal | 26 (100.0%) | |
Hypothyroidism | 0 (0.0%) | |
USG Neck
| 0.7752 | |
Tirads 1 | 3 (11.5%) | |
Tirads 2 | 13 (50.0%) | |
Tirads 3 | 0 (0.0%) | |
Tirads 4 | 9 (34.6%) | |
Tirads 5 | 1 (3.8%) | |
Thyroiditis | 0 (0.0%) | |
Solitary Thyroid Nodule | 0 (0.0%) | |
FNAC: Colloid Goiter (Yes)
| 10 (38.5%) | 0.2263 |
FNAC: Adenomatoid Nodule (Yes)
| 0 (0.0%) | 0.1492 |
FNAC: Papillary Carcinoma (Yes)
| 5 (19.2%) | 0.1432 |
FNAC: Nodular Goiter (Yes)
| 2 (7.7%) | 0.5522 |
FNAC: Follicular Neoplasm (Yes)
| 5 (19.2%) | 0.7542 |
FNAC: Thyroiditis (Yes)
| 1 (3.8%) | 1.0002 |
FNAC: Others (Yes)
| 3 (11.5%) | 1.0002 |
Procedure
| 0.0782 | |
Near Total Thyroidectomy | 0 (0.0%) | |
Total Thyroidectomy | 26 (100.0%) | |
Parathyroid (Preserved)
| 26 (100.0%) | 1.0003 |
Inferior Thyroid Artery (Preserved)
| 26 (100.0%) | 1.0003 |
Vitamin D (ng/mL) (Pre-Operative)
| 20.18 ± 9.53 | 0.7714 |
Vitamin D (Pre-Operative)
| 0.5372 | |
<20 ng/mL | 15 (57.7%) | |
20–30 ng/mL | 8 (30.8%) | |
≥30 ng/mL | 3 (11.5%) | |
PTH (pg/mL) (Pre-Operative)
| 47.46 ± 22.85 | 0.7894 |
PTH (pg/mL) (Post-Operative 4 h)***
| 11.45 ± 11.20 | < 0.0014 |
PTH (Pre-Operative)
| 1.0002 | |
15–65 pg/mL | 22 (84.6%) | |
>65 pg/mL | 4 (15.4%) | |
PTH (Post-Operative 4 h)***
| < 0.0013 | |
<15 pg/mL | 20 (76.9%) | |
15–65 pg/mL | 6 (23.1%) | |
Calcium (mg/dL) (Pre-Operative)
| 9.03 ± 0.40 | 0.1374 |
Calcium (mg/dL) (POD 1)***
| 7.93 ± 0.58 | < 0.0011 |
Calcium (mg/dL) (POD 2–4)***
| 7.48 ± 0.64 | < 0.0011 |
Calcium (mg/dL) (3 Months)***
| 8.79 ± 1.05 | 0.0384 |
Biochemical Hypocalcemia (Pre-Operative) (Yes)
| 3 (11.5%) | 1.0002 |
Biochemical Hypocalcemia (POD 1) (Yes)***
| 22 (84.6%) | 0.0013 |
Biochemical Hypocalcemia (POD 2–4) (Yes)***
| 25 (96.2%) | 0.0013 |
Biochemical Hypocalcemia (3 Months) (Yes)***
| 7 (30.4%) | 0.0372 |
Biochemical Hypocalcemia (Yes)***
| 25 (100.0%) | 0.0013 |
Post Operative Complications
| 0.2892 | |
No | 26 (100.0%) | |
Horseness Of Voice | 0 (0.0%) | |
Post Operative Management: No (Yes)***
| 1 (3.8%) | 0.0023 |
Post Operative Management: IV Calcium (Yes)***
| 17 (65.4%) | < 0.0013 |
Post Operative Management: Oral Calcium (Yes)***
| 25 (96.2%) | 0.0013 |
Post Operative Management: Vitamin D (Yes)***
| 13 (50.0%) | < 0.0013 |
Discharged Oral Calcium and vitamin D supplementation(Yes)***
| 24 (96.0%) | 0.0043 |
Final HPE Impression
| 0.7753 | |
Benign | 18 (69.2%) | |
Malignant | 8 (30.8%) | |
Change in PTH (pg/mL) (Post-Operative 4 h)***
| -36.01 ± 22.89 | 0.0014 |
PTH | Mean ± SD, Frequency (%) |
---|---|
Pre-Operative | |
15–65 pg/mL | 59 (84.3%) |
>65 pg/mL | 11 (15.7%) |
Post-Operative 4 h
| |
<15 pg/mL | 28 (40.0%) |
15–65 pg/mL | 42 (60.0%) |
Calcium (mg/dL)
|
Mean ± SD
|
Pre-Operative
| 9.07 ± 0.41 |
POD 1
| 8.33 ± 0.62 |
POD 2–4
| 8.08 ± 0.73 |
3 Months
| 9.11 ± 0.80 |
Vitamin D (Pre-Operative) | Frequency |
---|---|
< 20 ng/mL
| 43 (61.4%) |
20–30 ng/mL
| 22 (31.4%) |
≥ 30 ng/mL
| 5 (7.1%) |
Hypocalcemia
| Yes |
Biochemical Hypocalcemia
| 51 (73.9%) |
Symptomatic Hypocalcemia
| 26 (37.1%) |
Biochemical Hypocalcemia | Yes |
---|---|
POD 1
| 42 (60.0%) |
POD 2–4
| 51 (73.9%) |
3 Months
| 10 (16.9%) |
Parameter | 4 h post operative PTH Value (95% CI) | Change in PTH Value (95% CI) | Vitamin D Value (95% CI)e (95% CI) |
---|---|---|---|
Cutoff (p value) | ≤ 15.1 (0.017) | ≤ -22.7 (0.05) | ≤ 19.49 (0.074) |
AUROC | 0.707 (0.589–0.826) | 0.666 (0.508–0.823) | 0.656 (0.488–0.823) |
Sensitivity | 51.8% (38–65) | 57.1% (43–70) | 67.9% (54–80) |
Specificity |
100.0% (77–100)
|
78.6% (49–95)
| 71.4% (42–92) |
Positive Predictive Value |
100.0% (88–100)
|
91.4% (77–98)
| 90.5% (77–97) |
Negative Predictive Value | 34.1% (20–51) | 31.4% (17–49) | 35.7% (19–56) |
Diagnostic Accuracy | 61.4% (49–73) | 61.4% (49–73) |
68.6% (56–79)
|
Positive Likelihood Ratio | Inf (NaN-Inf) | 2.67 (0.95–7.46) | 2.38 (1.02–5.54) |
Negative Likelihood Ratio | 0.48 (0.37–0.63) | 0.55 (0.36–0.82) | 0.45 (0.27–0.75) |
Diagnostic Odds Ratio | Inf (NaN-Inf) | 4.89 (1.23–19.47) | 5.28 (1.46–19.14) |
Parameter | Post operative 4 h PTH Value (95% CI) | Change in PTH (95% CI) | Vitamin D Value (95% CI) |
---|---|---|---|
Cutoff (p value) | ≤ 9.1 (< 0.001) | ≤ -13.3 (0.001) | ≥ 25.06 (0.771) |
AUROC | 0.847 (0.742–0.952) | 0.734 (0.612–0.855) | 0.521 (0.371–0.672) |
Sensitivity | 76.9% (56–91) | 92.3% (75–99) | 34.6% (17–56) |
Specificity | 88.6% (75–96) | 47.7% (32–63) | 84.1% (70–93) |
Positive Predictive Value | 80.0% (59–93) | 51.1% (36–66) | 56.2% (30–80) |
Negative Predictive Value | 86.7% (73–95) | 91.3% (72–99) | 68.5% (54–80) |
Diagnostic Accuracy | 84.3% (74–92) | 64.3% (52–75) | 65.7% (53–77) |
Positive Likelihood Ratio | 6.77 (2.89–15.86) | 1.77 (1.3–2.39) | 2.18 (0.92–5.14) |
Negative Likelihood Ratio | 0.26 (0.13–0.53) | 0.16 (0.04–0.63) | 0.78 (0.57–1.06) |
Diagnostic Odds Ratio | 26 (7.06–95.74) | 10.96 (2.3-52.09) | 2.8 (0.89–8.77) |