Which intraoperative parathyroid hormone assay criterion best predicts operative success?
HYPOTHESIS: The 6 published criteria for predicting curative parathyroid resection by means of intraoperative parathyroid hormone (IOPTH) assay are not equivalent. DESIGN: Retrospective review of 352 patients undergoing parathyroidectomy for primary hyperparathyroidism from January 1, 1999, to December 31, 2004. We evaluated 6-month postoperative IOPTH values and serum calcium levels. SETTING: Tertiary referral center. MAIN OUTCOME MEASURES: The IOPTH values at baseline (preincision and preexcision) and at 5 and 10 minutes after parathyroidectomy were reviewed according to the Miami criterion (>50% drop from highest baseline IOPTH level at 10 minutes after excision), criterion 1 (>50% drop from preincision IOPTH level at 10 minutes), criterion 2 (>50% drop from highest baseline IOPTH level at 10 minutes and final IOPTH level within the reference range), criterion 3 (>50% drop from highest baseline IOPTH level at 10 minutes and final IOPTH level less than the preincision value), criteri