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PH was defined as a serum parathyroid hormone (PTH) level\u2009&lt;\u200915 pg\/mL and the need for active vitamin D, with or without calcium supplementation, to prevent hypocalcemic symptoms persisting for at least 6 months postoperatively. Patients were categorized according to PH status, and clinical, surgical, and biochemical parameters were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 498 eligible patients, 18 (3.6%) developed PH. A postoperative day 1 PTH level\u2009\u2264\u20097 pg\/mL predicted PH with 86.7% sensitivity and 90.3% specificity and was an independent risk factor in multivariate analysis (odds ratio [OR]: 16.60,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Completion thyroidectomy was also independently associated with PH (OR: 6.14,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). Postoperative day 1 calcium\u2009\u2264\u20098.3\u00a0mg\/dL (OR: 14.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and the presence of parathyroid tissue in the surgical specimen (OR: 6.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were significant in univariate analysis but not in multivariate analysis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.056, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Permanent hypoparathyroidism remains a clinically significant complication of thyroidectomy, with an incidence of 3.6% in our cohort. A postoperative day 1 PTH\u2009\u2264\u20097 pg\/mL was independently associated with PH and demonstrated an excellent negative predictive value (99.4%), supporting its clinical utility for ruling out PH rather than confidently predicting it. Completion thyroidectomy was also independently associated with PH. Given the limited number of events, these findings warrant validation in larger, prospective cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12902-026-02369-w","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:17:08Z","timestamp":1782404228000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predicting permanent hypoparathyroidism after thyroidectomy: role of early postoperative parathyroid hormone levels and surgical factors"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9470-4249","authenticated-orcid":false,"given":"Ahmet","family":"Akmercan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9944-6998","authenticated-orcid":false,"given":"Kerim Deniz","family":"Batun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7224-3592","authenticated-orcid":false,"given":"Ahmet Hakan","family":"Atalay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9233-0570","authenticated-orcid":false,"given":"Muhammer","family":"Ergen\u00e7","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6475-0615","authenticated-orcid":false,"given":"Bahadir M.","family":"G\u00fcll\u00fco\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4757-5560","authenticated-orcid":false,"given":"M. \u00dcmit","family":"U\u011furlu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"2369_CR1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1159\/000491043","volume":"51","author":"L Cianferotti","year":"2019","unstructured":"Cianferotti L. 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Br J Surg. 2015;102(4):359\u201367. https:\/\/doi.org\/10.1002\/bjs.9676.","journal-title":"Br J Surg"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-026-02369-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02369-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-026-02369-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:12:24Z","timestamp":1789085544000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12902-026-02369-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2369"],"URL":"https:\/\/doi.org\/10.1186\/s12902-026-02369-w","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"assertion":[{"value":"18 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Part of the data included in this manuscript was presented as an oral presentation at the 12th National Congress of Endocrine Surgery, held in Antalya, Turkey, between February 13 and 16, 2025.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki, and this study was approved by the Marmara University School of Medicine Clinical Research Ethics Committee (Number: 09.2024.1071). Due to the retrospective nature of the study, the requirement for informed consent was waived by the Ethics Committee.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The initial draft of this article was written in Turkish and later translated into English using DeepL Translator (deepl.com\/en\/translator). To enhance grammar, language quality, readability, and proofreading, the author utilized Grammarly (app.grammarly.com), Trinka AI (trinka.ai), and ChatGPT (chat.openai.com). These tools were employed exclusively for AI-assisted copy editing purposes, such as improving grammar, style, and clarity, without autonomous content generation. After using these tools, the author thoroughly reviewed, edited, and approved the final version, and takes full responsibility for the published work.","order":4,"name":"Ethics","label":"Declaration of Generative AI and AI-assisted technologies in the writing process","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"267"}}