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. 2014 Apr;96(3):219-23.
doi: 10.1308/003588414X13814021679753.

Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit

O Edafe  1 , P Prasad, B J Harrison, S P Balasubramanian
Affiliations

Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit

O Edafe et al. Ann R Coll Surg Engl. 2014 Apr.

Abstract

Background: Post-thyroidectomy hypocalcaemia is a common complication with significant short and long term morbidity. The aim of this study was to determine the incidence and predictors of post-thyroidectomy hypocalcaemia (as defined by a corrected calcium <2.1 mmol/l) in a tertiary endocrine surgical unit.

Methods: A total of 238 consecutive patients who underwent completion or bilateral thyroid surgery between 2008 and 2011 were included in this retrospective study. Clinical and biochemical data were obtained from electronic and hard copy medical records.

Results: The incidence of post-thyroidectomy hypocalcaemia on first postoperative day (POD1) was 29.0%. There was variation in the incidence of hypocalcaemia depending on the timing of measurement on the first postoperative day. At six months following surgery, 5.5% of patients were on calcium and/or vitamin D supplementation. Factors associated with post-thyroidectomy hypocalcaemia were lower preoperative corrected calcium (p=0.005) and parathyroid gland (PTG) auto-transplant (p=0.001). Other clinical factors such as central lymph node dissection, inadvertent PTG excision, ethnicity, preoperative diagnosis and Lugol's iodine were not associated with post-thyroidectomy hypocalcaemia.

Conclusion: The incidence of post-thyroidectomy hypocalcaemia was underestimated by 6% when only POD1 measurements were considered. The timing of measurement on POD1 has an impact on the incidence of post-thyroidectomy hypocalcaemia. Auto-transplantation and lower preoperative calcium were associated with post-thyroidectomy hypocalcaemia.

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Figures

Figure 1
Figure 1
Twenty patients who became normocalcaemic in the afternoon after being hypocalcaemic in the morning of the first postoperative day
Figure 2
Figure 2
Eleven patients who had hypocalcaemia in the afternoon despite being normocalcaemic in the morning of the first postoperative day
See this image and copyright information in PMC

References

    1. Manouras A, Markogiannakis H, Lagoudianakis E et al Unintentional parathyroidectomy during total thyroidectomy. Head Neck 2008; 30: 497–502. - PubMed
    1. Wu SD, Gao L. Is routine calcium supplementation necessary in patients undergoing total thyroidectomy plus neck dissection? Surg Today 2011; 41: 183–188. - PubMed
    1. Chadwick D, Kinsman R, Walton P, Systems DC. The British Association of Endocrine and Thyroid Surgeon Fourth National Audit. Henley-on-Thames: Dendrite Clinical Systems Ltd; 2012.
    1. Bourrel C, Uzzan B, Tison P et al Transient hypocalcemia after thyroidectomy. Ann Otol Rhinol Laryngol 1993; 102: 496–501. - PubMed
    1. Sitges-Serra A, Ruiz S, Girvent M et al Outcome of protracted hypoparathyroidism after total thyroidectomy. Br J Surg 2010; 97: 1,687–1,695. - PubMed